Imaging in acute respiratory distress syndrome

Antonio Pesenti, Guido Musch, Daniel Lichtenstein, Francesco Mojoli, Marcelo B P Amato, Gilda Cinnella, Luciano Gattinoni, Michael Quintel

Research output: Contribution to journalArticle

Abstract

Purpose: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS). Methods: This review addresses the use of imaging techniques for the diagnosis and management of ARDS as well as gaining knowledge about its pathogenesis and pathophysiology. The techniques described in this article are computed tomography, positron emission tomography, and two easily accessible imaging techniques available at the bedside—ultrasound and electrical impedance tomography (EIT). Results: The use of computed tomography has provided new insights into ARDS pathophysiology, demonstrating that ARDS does not homogeneously affect the lung parenchyma and that lung injury severity is widely distributed in the ARDS population. Positron emission tomography is a functional imaging technique whose value resides in adding incremental insights to morphological imaging. It can quantify regional perfusion, ventilation, aeration, lung vascular permeability, edema, and inflammation. Lung ultrasound and EIT are radiation-free, noninvasive tools available at the bedside. Lung ultrasound can provide useful information on ARDS diagnosis when x-rays or CT scan are not available. EIT is a useful tool to monitor lung ventilation and to assess the regional distribution of perfusion. Conclusions: The future of imaging in critical care will probably develop in two main directions: easily accessible imaging techniques that can be used at the bedside and sophisticated imaging methods that will be used to aid in difficult diagnostic cases or to advance our understanding of the pathogenesis and pathophysiology of an array of critical illnesses.

Original languageEnglish
Pages (from-to)686-698
Number of pages13
JournalIntensive Care Medicine
Volume42
Issue number5
DOIs
Publication statusPublished - May 1 2016

Fingerprint

Adult Respiratory Distress Syndrome
Lung
Electric Impedance
Tomography
Ventilation
Perfusion
Capillary Permeability
Lung Injury
Critical Care
Critical Illness
Positron-Emission Tomography
Edema
X-Rays
Medicine
Radiation
Inflammation
Population

Keywords

  • Acute respiratory distress syndrome
  • Computed tomography
  • Electrical impedance tomography
  • Lung ultrasound
  • Positron emission tomography

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Pesenti, A., Musch, G., Lichtenstein, D., Mojoli, F., Amato, M. B. P., Cinnella, G., ... Quintel, M. (2016). Imaging in acute respiratory distress syndrome. Intensive Care Medicine, 42(5), 686-698. https://doi.org/10.1007/s00134-016-4328-1

Imaging in acute respiratory distress syndrome. / Pesenti, Antonio; Musch, Guido; Lichtenstein, Daniel; Mojoli, Francesco; Amato, Marcelo B P; Cinnella, Gilda; Gattinoni, Luciano; Quintel, Michael.

In: Intensive Care Medicine, Vol. 42, No. 5, 01.05.2016, p. 686-698.

Research output: Contribution to journalArticle

Pesenti, A, Musch, G, Lichtenstein, D, Mojoli, F, Amato, MBP, Cinnella, G, Gattinoni, L & Quintel, M 2016, 'Imaging in acute respiratory distress syndrome', Intensive Care Medicine, vol. 42, no. 5, pp. 686-698. https://doi.org/10.1007/s00134-016-4328-1
Pesenti A, Musch G, Lichtenstein D, Mojoli F, Amato MBP, Cinnella G et al. Imaging in acute respiratory distress syndrome. Intensive Care Medicine. 2016 May 1;42(5):686-698. https://doi.org/10.1007/s00134-016-4328-1
Pesenti, Antonio ; Musch, Guido ; Lichtenstein, Daniel ; Mojoli, Francesco ; Amato, Marcelo B P ; Cinnella, Gilda ; Gattinoni, Luciano ; Quintel, Michael. / Imaging in acute respiratory distress syndrome. In: Intensive Care Medicine. 2016 ; Vol. 42, No. 5. pp. 686-698.
@article{542a749057cf4d3fb62e482843efd5e5,
title = "Imaging in acute respiratory distress syndrome",
abstract = "Purpose: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS). Methods: This review addresses the use of imaging techniques for the diagnosis and management of ARDS as well as gaining knowledge about its pathogenesis and pathophysiology. The techniques described in this article are computed tomography, positron emission tomography, and two easily accessible imaging techniques available at the bedside—ultrasound and electrical impedance tomography (EIT). Results: The use of computed tomography has provided new insights into ARDS pathophysiology, demonstrating that ARDS does not homogeneously affect the lung parenchyma and that lung injury severity is widely distributed in the ARDS population. Positron emission tomography is a functional imaging technique whose value resides in adding incremental insights to morphological imaging. It can quantify regional perfusion, ventilation, aeration, lung vascular permeability, edema, and inflammation. Lung ultrasound and EIT are radiation-free, noninvasive tools available at the bedside. Lung ultrasound can provide useful information on ARDS diagnosis when x-rays or CT scan are not available. EIT is a useful tool to monitor lung ventilation and to assess the regional distribution of perfusion. Conclusions: The future of imaging in critical care will probably develop in two main directions: easily accessible imaging techniques that can be used at the bedside and sophisticated imaging methods that will be used to aid in difficult diagnostic cases or to advance our understanding of the pathogenesis and pathophysiology of an array of critical illnesses.",
keywords = "Acute respiratory distress syndrome, Computed tomography, Electrical impedance tomography, Lung ultrasound, Positron emission tomography",
author = "Antonio Pesenti and Guido Musch and Daniel Lichtenstein and Francesco Mojoli and Amato, {Marcelo B P} and Gilda Cinnella and Luciano Gattinoni and Michael Quintel",
year = "2016",
month = "5",
day = "1",
doi = "10.1007/s00134-016-4328-1",
language = "English",
volume = "42",
pages = "686--698",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Imaging in acute respiratory distress syndrome

AU - Pesenti, Antonio

AU - Musch, Guido

AU - Lichtenstein, Daniel

AU - Mojoli, Francesco

AU - Amato, Marcelo B P

AU - Cinnella, Gilda

AU - Gattinoni, Luciano

AU - Quintel, Michael

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Purpose: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS). Methods: This review addresses the use of imaging techniques for the diagnosis and management of ARDS as well as gaining knowledge about its pathogenesis and pathophysiology. The techniques described in this article are computed tomography, positron emission tomography, and two easily accessible imaging techniques available at the bedside—ultrasound and electrical impedance tomography (EIT). Results: The use of computed tomography has provided new insights into ARDS pathophysiology, demonstrating that ARDS does not homogeneously affect the lung parenchyma and that lung injury severity is widely distributed in the ARDS population. Positron emission tomography is a functional imaging technique whose value resides in adding incremental insights to morphological imaging. It can quantify regional perfusion, ventilation, aeration, lung vascular permeability, edema, and inflammation. Lung ultrasound and EIT are radiation-free, noninvasive tools available at the bedside. Lung ultrasound can provide useful information on ARDS diagnosis when x-rays or CT scan are not available. EIT is a useful tool to monitor lung ventilation and to assess the regional distribution of perfusion. Conclusions: The future of imaging in critical care will probably develop in two main directions: easily accessible imaging techniques that can be used at the bedside and sophisticated imaging methods that will be used to aid in difficult diagnostic cases or to advance our understanding of the pathogenesis and pathophysiology of an array of critical illnesses.

AB - Purpose: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS). Methods: This review addresses the use of imaging techniques for the diagnosis and management of ARDS as well as gaining knowledge about its pathogenesis and pathophysiology. The techniques described in this article are computed tomography, positron emission tomography, and two easily accessible imaging techniques available at the bedside—ultrasound and electrical impedance tomography (EIT). Results: The use of computed tomography has provided new insights into ARDS pathophysiology, demonstrating that ARDS does not homogeneously affect the lung parenchyma and that lung injury severity is widely distributed in the ARDS population. Positron emission tomography is a functional imaging technique whose value resides in adding incremental insights to morphological imaging. It can quantify regional perfusion, ventilation, aeration, lung vascular permeability, edema, and inflammation. Lung ultrasound and EIT are radiation-free, noninvasive tools available at the bedside. Lung ultrasound can provide useful information on ARDS diagnosis when x-rays or CT scan are not available. EIT is a useful tool to monitor lung ventilation and to assess the regional distribution of perfusion. Conclusions: The future of imaging in critical care will probably develop in two main directions: easily accessible imaging techniques that can be used at the bedside and sophisticated imaging methods that will be used to aid in difficult diagnostic cases or to advance our understanding of the pathogenesis and pathophysiology of an array of critical illnesses.

KW - Acute respiratory distress syndrome

KW - Computed tomography

KW - Electrical impedance tomography

KW - Lung ultrasound

KW - Positron emission tomography

UR - http://www.scopus.com/inward/record.url?scp=84962162117&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962162117&partnerID=8YFLogxK

U2 - 10.1007/s00134-016-4328-1

DO - 10.1007/s00134-016-4328-1

M3 - Article

AN - SCOPUS:84962162117

VL - 42

SP - 686

EP - 698

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 5

ER -