Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study

L. Gattinoni, D. Mascheroni, A. Torresin, R. Marcolin, R. Fumagalli, S. Vesconi, G. P. Rossi, F. Rossi, S. Baglioni, F. Bassi, G. Nastri, A. Pesenti

Research output: Contribution to journalArticle

Abstract

Ten patients with acute respiratory failure (ARF), (4 pneumonia, 4 sepsis, 2 polytrauma), underwent computerized tomography (CT) of the lungs, (apex, hilum, base), at 5, 10, 15 cm H2O positive end expiratory pressure (PEEP). The ARF lungs, on CT scan, appeared as a patchwork of normal and dense areas with generally well defined boundaries. Most of the densities were found in the dependent regions. The areas of density were correlated with PaO2 (r=0.51). The PEEP increase resulted in a significant expansion of total cross-sectional lung surface area. The dense areas decreased significantly at the hilum and base when increasing PEEP while the changes at the apex were not significant. The changes of density with PEEP were highly correlated with the changes in oxygenation (r=0.91). In the individual patient, however, the modifications of gas exchange can not be entirely predicted from morphological changes, possibly due to a diversion of pulmonary blood flow.

Original languageEnglish
Pages (from-to)137-142
Number of pages6
JournalIntensive Care Medicine
Volume12
Issue number3
DOIs
Publication statusPublished - May 1986

Keywords

  • Acute respiratory failure
  • CT scan
  • PEEP

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Gattinoni, L., Mascheroni, D., Torresin, A., Marcolin, R., Fumagalli, R., Vesconi, S., Rossi, G. P., Rossi, F., Baglioni, S., Bassi, F., Nastri, G., & Pesenti, A. (1986). Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study. Intensive Care Medicine, 12(3), 137-142. https://doi.org/10.1007/BF00254928