Looking closer at acute respiratory distress syndrome: The role of advanced imaging techniques

Giacomo Bellani, Jean Jaques Rouby, Jean Michel Constantin, Antonio Pesenti

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review Advanced imaging techniques have provided invaluable insights in understanding of acute respiratory distress syndrome (ARDS) and the effect of therapeutic strategies, thanks to the possibility of gaining regional information and moving from simple 'anatomical' information to in-vivo functional imaging. Recent findings Computed tomography (CT) led to the understanding of several ARDS mechanisms and interaction with mechanical ventilation. It is nowadays frequently part of routine diagnostic workup, often leading to treatment changes. Moreover, CT is a reference for novel techniques both in clinical and preclinical studies. Bedside transthoracic lung ultrasound allows semiquantitative regional analysis of lung aeration, identifies ARDS lung morphology and response to therapeutic maneuvers. Electrical impedance tomography is a radiation-free, functional, bedside, imaging modality which allows a real-time monitoring of regional ventilation. Finally, positron emission tomography (PET) is a functional imaging technique that allows to trace physiologic processes, by administration of a radioactive molecule. PET with 18FDG has been applied to patients with ARDS, thanks to its ability to track the inflammatory cells activity. Summary Progresses in lung imaging are key to individualize therapy, diagnosis, and pathophysiological mechanism at play in any patient at any specified time, helping to move toward personalized medicine for ARDS.

Original languageEnglish
Pages (from-to)30-37
Number of pages8
JournalCurrent Opinion in Critical Care
Volume23
Issue number1
DOIs
Publication statusPublished - 2017

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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