The role of CT-scan studies for the diagnosis and therapy of acute respiratory distress syndrome.
CT has provided new insights on the pathophysiology of acute respiratory distress syndrome (ARDS), demonstrating that ARDS does not affect the lung parenchyma homogeneously. These findings suggest that lung edema, as assessed by CT scan, should be included in the definition. Lung CT findings may provide a firm rationale for tailoring tidal volume during mechanical ventilation. Ideally, tidal volume should be proportional to the portion of the lung open to ventilation, as assessed by CT scan, rather than to the body weight. CT assessment of lung recruitability seems to be a prerequisite for a rational setting of positive end-expiratory pressure.
Gattinoni
Luciano
L
Istituto di Anestesiologia e Rianimazione, Dipartimento di Anestesia, Rianimazione, e Terapia del Dolore, Fondazione IRCCS-Ospedale Maggiore Policlinico, Mangiagalli, Università degli Studi di Milano, Milano, Italy. gattinon@policlinico.mi.it
Caironi
Pietro
P
Valenza
Franco
F
Carlesso
Eleonora
E
D006801:Humans; D011175:Positive-Pressure Respiration / Q000379:methods*; D015203:Reproducibility of Results; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome