Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations

Lawrence R. Goodman, Roberto Fumagalli, Paola Tagliabue, Marcello Tagliabue, Marco Ferrario, Luciano Gattinoni, Antonio Pesenti

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

PURPOSE: To assess the differences in CT appearance between adult respiratory distress syndrome due to pulmonary disease (ARDS(p)) and that due to extrapulmonary-disease (ARDS(EXP)) and determine whether the variable appearances of ARDS are due, in part to the initial pulmonary and systemic causes. MATERIALS AND METHODS: Thirty-three patients, 22 with ARDS(p) and 11 with ARDS(EXP), underwent helical CT shortly after intubation. Two readers evaluated images for the type, extent, and distribution of pulmonary opacities; secondary findings; and correlation with survival and physiologic parameters. RESULTS: In both ARDS(p) and ARDS(EXP), approximately 80% of the lung was abnormal. In ARDS(p), ground-glass opacification and consolidation were equally prevalent, whereas in ARDS(EXP) ground-glass opacification was dominant. Ground-glass opacification was evenly distributed, whereas consolidation tended to be dorsal and caudal. ARDS(p) often caused asymmetric consolidation, whereas ARDS(EXP) caused symmetric ground-glass opacification. Air bronchograms were almost universal. Pleural effusions were present in one-half of the patients, and Kerley B lines and pneumatoceles were uncommon. Lung consolidation correlated with the ratio of mean partial pressure of arterial oxygen to fraction of inspired oxygen, shunt fraction, and pulmonary arterial pressure. The patients who died tended to have more consolidation and asymmetric disease. CONCLUSION: ARDS(p) tends to be asymmetric, with a mix of consolidation and ground-glass opacification, whereas ARDS(EXP) has predominantly symmetric ground-glass opacification. In both groups, pleural effusions and air bronchograms are common, and Kerley B lines and pneumatoceles are uncommon.

Original languageEnglish
Pages (from-to)545-552
Number of pages8
JournalRadiology
Volume213
Issue number2
Publication statusPublished - Nov 1999

Fingerprint

Adult Respiratory Distress Syndrome
Glass
Lung
Pleural Effusion
Air
Oxygen
Partial Pressure
Spiral Computed Tomography
Intubation
Lung Diseases
Arterial Pressure
Survival

Keywords

  • Computed tomography (CT), helical
  • Lung, consolidation
  • Lung, CT
  • Lung, diseases
  • Respiratory distress syndrome, adult (ARDS)

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Goodman, L. R., Fumagalli, R., Tagliabue, P., Tagliabue, M., Ferrario, M., Gattinoni, L., & Pesenti, A. (1999). Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations. Radiology, 213(2), 545-552.

Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes : CT, clinical, and functional correlations. / Goodman, Lawrence R.; Fumagalli, Roberto; Tagliabue, Paola; Tagliabue, Marcello; Ferrario, Marco; Gattinoni, Luciano; Pesenti, Antonio.

In: Radiology, Vol. 213, No. 2, 11.1999, p. 545-552.

Research output: Contribution to journalArticle

Goodman, LR, Fumagalli, R, Tagliabue, P, Tagliabue, M, Ferrario, M, Gattinoni, L & Pesenti, A 1999, 'Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations', Radiology, vol. 213, no. 2, pp. 545-552.
Goodman LR, Fumagalli R, Tagliabue P, Tagliabue M, Ferrario M, Gattinoni L et al. Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations. Radiology. 1999 Nov;213(2):545-552.
Goodman, Lawrence R. ; Fumagalli, Roberto ; Tagliabue, Paola ; Tagliabue, Marcello ; Ferrario, Marco ; Gattinoni, Luciano ; Pesenti, Antonio. / Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes : CT, clinical, and functional correlations. In: Radiology. 1999 ; Vol. 213, No. 2. pp. 545-552.
@article{7f79ee676ae141e0b395b319157f7328,
title = "Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations",
abstract = "PURPOSE: To assess the differences in CT appearance between adult respiratory distress syndrome due to pulmonary disease (ARDS(p)) and that due to extrapulmonary-disease (ARDS(EXP)) and determine whether the variable appearances of ARDS are due, in part to the initial pulmonary and systemic causes. MATERIALS AND METHODS: Thirty-three patients, 22 with ARDS(p) and 11 with ARDS(EXP), underwent helical CT shortly after intubation. Two readers evaluated images for the type, extent, and distribution of pulmonary opacities; secondary findings; and correlation with survival and physiologic parameters. RESULTS: In both ARDS(p) and ARDS(EXP), approximately 80{\%} of the lung was abnormal. In ARDS(p), ground-glass opacification and consolidation were equally prevalent, whereas in ARDS(EXP) ground-glass opacification was dominant. Ground-glass opacification was evenly distributed, whereas consolidation tended to be dorsal and caudal. ARDS(p) often caused asymmetric consolidation, whereas ARDS(EXP) caused symmetric ground-glass opacification. Air bronchograms were almost universal. Pleural effusions were present in one-half of the patients, and Kerley B lines and pneumatoceles were uncommon. Lung consolidation correlated with the ratio of mean partial pressure of arterial oxygen to fraction of inspired oxygen, shunt fraction, and pulmonary arterial pressure. The patients who died tended to have more consolidation and asymmetric disease. CONCLUSION: ARDS(p) tends to be asymmetric, with a mix of consolidation and ground-glass opacification, whereas ARDS(EXP) has predominantly symmetric ground-glass opacification. In both groups, pleural effusions and air bronchograms are common, and Kerley B lines and pneumatoceles are uncommon.",
keywords = "Computed tomography (CT), helical, Lung, consolidation, Lung, CT, Lung, diseases, Respiratory distress syndrome, adult (ARDS)",
author = "Goodman, {Lawrence R.} and Roberto Fumagalli and Paola Tagliabue and Marcello Tagliabue and Marco Ferrario and Luciano Gattinoni and Antonio Pesenti",
year = "1999",
month = "11",
language = "English",
volume = "213",
pages = "545--552",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes

T2 - CT, clinical, and functional correlations

AU - Goodman, Lawrence R.

AU - Fumagalli, Roberto

AU - Tagliabue, Paola

AU - Tagliabue, Marcello

AU - Ferrario, Marco

AU - Gattinoni, Luciano

AU - Pesenti, Antonio

PY - 1999/11

Y1 - 1999/11

N2 - PURPOSE: To assess the differences in CT appearance between adult respiratory distress syndrome due to pulmonary disease (ARDS(p)) and that due to extrapulmonary-disease (ARDS(EXP)) and determine whether the variable appearances of ARDS are due, in part to the initial pulmonary and systemic causes. MATERIALS AND METHODS: Thirty-three patients, 22 with ARDS(p) and 11 with ARDS(EXP), underwent helical CT shortly after intubation. Two readers evaluated images for the type, extent, and distribution of pulmonary opacities; secondary findings; and correlation with survival and physiologic parameters. RESULTS: In both ARDS(p) and ARDS(EXP), approximately 80% of the lung was abnormal. In ARDS(p), ground-glass opacification and consolidation were equally prevalent, whereas in ARDS(EXP) ground-glass opacification was dominant. Ground-glass opacification was evenly distributed, whereas consolidation tended to be dorsal and caudal. ARDS(p) often caused asymmetric consolidation, whereas ARDS(EXP) caused symmetric ground-glass opacification. Air bronchograms were almost universal. Pleural effusions were present in one-half of the patients, and Kerley B lines and pneumatoceles were uncommon. Lung consolidation correlated with the ratio of mean partial pressure of arterial oxygen to fraction of inspired oxygen, shunt fraction, and pulmonary arterial pressure. The patients who died tended to have more consolidation and asymmetric disease. CONCLUSION: ARDS(p) tends to be asymmetric, with a mix of consolidation and ground-glass opacification, whereas ARDS(EXP) has predominantly symmetric ground-glass opacification. In both groups, pleural effusions and air bronchograms are common, and Kerley B lines and pneumatoceles are uncommon.

AB - PURPOSE: To assess the differences in CT appearance between adult respiratory distress syndrome due to pulmonary disease (ARDS(p)) and that due to extrapulmonary-disease (ARDS(EXP)) and determine whether the variable appearances of ARDS are due, in part to the initial pulmonary and systemic causes. MATERIALS AND METHODS: Thirty-three patients, 22 with ARDS(p) and 11 with ARDS(EXP), underwent helical CT shortly after intubation. Two readers evaluated images for the type, extent, and distribution of pulmonary opacities; secondary findings; and correlation with survival and physiologic parameters. RESULTS: In both ARDS(p) and ARDS(EXP), approximately 80% of the lung was abnormal. In ARDS(p), ground-glass opacification and consolidation were equally prevalent, whereas in ARDS(EXP) ground-glass opacification was dominant. Ground-glass opacification was evenly distributed, whereas consolidation tended to be dorsal and caudal. ARDS(p) often caused asymmetric consolidation, whereas ARDS(EXP) caused symmetric ground-glass opacification. Air bronchograms were almost universal. Pleural effusions were present in one-half of the patients, and Kerley B lines and pneumatoceles were uncommon. Lung consolidation correlated with the ratio of mean partial pressure of arterial oxygen to fraction of inspired oxygen, shunt fraction, and pulmonary arterial pressure. The patients who died tended to have more consolidation and asymmetric disease. CONCLUSION: ARDS(p) tends to be asymmetric, with a mix of consolidation and ground-glass opacification, whereas ARDS(EXP) has predominantly symmetric ground-glass opacification. In both groups, pleural effusions and air bronchograms are common, and Kerley B lines and pneumatoceles are uncommon.

KW - Computed tomography (CT), helical

KW - Lung, consolidation

KW - Lung, CT

KW - Lung, diseases

KW - Respiratory distress syndrome, adult (ARDS)

UR - http://www.scopus.com/inward/record.url?scp=0032732936&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032732936&partnerID=8YFLogxK

M3 - Article

C2 - 10551239

AN - SCOPUS:0032732936

VL - 213

SP - 545

EP - 552

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -