Inflammatory pulmonary edema and positive end-expiratory pressure: Correlations between imaging and physiologic studies

L. Gattinoni, A. Pesenti, S. Baglioni, G. Vitale, M. Rivolta, P. Pelosi

Research output: Contribution to journalArticle

Abstract

The anatomic and physiologic response to positive end-expiratory pressure (PEEP) was investigated using computed tomography (CT) in patients with adult respiratory distress syndrome (ARDS). The lesions (densities) in ARDS are distributed inhomogeneously but tend to concentrate in the dependent regions. The estimated lung weight (by CT scan, quantitative analysis, and lung gas volume measured with helium dilution) is, on the average, 200% higher than expected. Changing the body position from supine to prone causes a change in the density distribution in response to gravitational forces. The main effect of PEEP is to clear the densities through alveolar anatomic recruitment. Anatomic recruitment changes the mechanical characteristics of the lung and parallels the improvement in gas exchange. The effects of PEEP on pulmonary arterial pressure appear to be related to anatomic recruitment.

Original languageEnglish
JournalJournal of Thoracic Imaging
Volume3
Issue number3
Publication statusPublished - 1988

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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    Gattinoni, L., Pesenti, A., Baglioni, S., Vitale, G., Rivolta, M., & Pelosi, P. (1988). Inflammatory pulmonary edema and positive end-expiratory pressure: Correlations between imaging and physiologic studies. Journal of Thoracic Imaging, 3(3).