Daily changes of the area of density in the dependent lung region - evaluation using transesophageal echocardiography.
OBJECTIVE
To evaluate the daily changes of the area of density using transesophageal echocardiography (TEE) in acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) patients.


METHODS
Retrospective observational study.


METHODS
General ICU in a university hospital.


METHODS
Fifteen patients with ARDS or ALI who underwent TEE examination for more than 5 days.


METHODS
Densities in the lower left lung region were observed through the descending aorta by TEE. Daily changes of the area of density were evaluated. The areas of density estimated by TEE were compared with those obtained by computed tomography (CT). The relation between the area of density and PaO(2)/FIO(2)was calculated.


RESULTS
The area of density in the dependent lung region measured by TEE was 11.1+/-5.7 cm(2) (mean +/- SD) at the mid-esophageal position. The area of density in ARDS patients changed daily from 12.0+/-2.8 cm(2) to 8.5+/-6.7 cm(2). The areas of density evaluated using TEE in the left lung correlated significantly with those estimated using CT ( r=0.72, p<0.01). In addition, we found a significant correlation between PaO(2)/FIO(2) and the area of density estimated by TEE ( r=-0.53, p<0.05).


CONCLUSIONS
Using TEE, we could evaluate daily changes of the area of density in the dependent lung region in the intensive care situation. The areas of density in ARDS patients changed from day to day following the changes of oxygenation.
Tsubo
T
T
Intensive Care Unit, University of Hirosaki School of Medicine, 036-8563 Hirosaki, Aomori-ken, Japan. tsubo@cc.hirosaki-u.ac.jp
Yatsu
Y
Y
Suzuki
A
A
Iwakawa
T
T
Okawa
H
H
Ishihara
H
H
Matsuki
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011175:Positive-Pressure Respiration; D015203:Reproducibility of Results; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed