Value of Computed Tomography of the Chest in Subjects With ARDS: A Retrospective Observational Study
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Value of Computed Tomography of the Chest in Subjects With ARDS: A Retrospective Observational Study. / Simon, Marcel; Braune, Stephan; Laqmani, Azien; Metschke, Maria; Berliner, Christoph; Kalsow, Maria; Klose, Hans; Kluge, Stefan.
In: RESP CARE, 03.2013.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Value of Computed Tomography of the Chest in Subjects With ARDS: A Retrospective Observational Study
AU - Simon, Marcel
AU - Braune, Stephan
AU - Laqmani, Azien
AU - Metschke, Maria
AU - Berliner, Christoph
AU - Kalsow, Maria
AU - Klose, Hans
AU - Kluge, Stefan
N1 - Copyright © 2015 by Daedalus Enterprises.
PY - 2013/3
Y1 - 2013/3
N2 - BACKGROUND: The value of computed tomography (CT) of the chest in the management of patients with ARDS is poorly defined. The aim of this study was to assess the clinical utility of thoracic CT scans in subjects with ARDS using the Berlin definition.METHODS: This was a retrospective, observational study in a university hospital ARDS center on all subjects with ARDS in whom a CT scan of the chest was performed immediately before or during an ICU stay between January 1, 2007 and June 30, 2013.RESULTS: During the study period, a total of 1,781 thoracic CT scans were performed, of which 204 cases met inclusion criteria. The most common pathologic findings of the lung parenchyma were consolidations (94.1% of cases) and ground glass opacities (85.3%). Furthermore, CT scans showed pleural effusions (80.4%), mediastinal lymphadenopathy (66.7%), signs of right ventricular strain and pulmonary hypertension (53.9%), pericardial effusion (37.3%), emphysema of the chest wall (12.3%), pneumothorax (11.8%), emphysema of the mediastinum (7.4%), and pulmonary embolism (2.5%). Results of CT scans led to changes in management in 26.5% of cases. Mortality was significantly increased in subjects with involvement of lung parenchyma of >80% (P = .004). Intrahospital transport was associated with critical incidents in 8.3% of cases.CONCLUSIONS: Systematic evaluation of thoracic CT scans yielded information useful for making a diagnosis, predicting prognosis, and recognizing concomitant disorders requiring therapeutic interventions. Results obtained from CT scans led to changes in management in 26.5% of cases.
AB - BACKGROUND: The value of computed tomography (CT) of the chest in the management of patients with ARDS is poorly defined. The aim of this study was to assess the clinical utility of thoracic CT scans in subjects with ARDS using the Berlin definition.METHODS: This was a retrospective, observational study in a university hospital ARDS center on all subjects with ARDS in whom a CT scan of the chest was performed immediately before or during an ICU stay between January 1, 2007 and June 30, 2013.RESULTS: During the study period, a total of 1,781 thoracic CT scans were performed, of which 204 cases met inclusion criteria. The most common pathologic findings of the lung parenchyma were consolidations (94.1% of cases) and ground glass opacities (85.3%). Furthermore, CT scans showed pleural effusions (80.4%), mediastinal lymphadenopathy (66.7%), signs of right ventricular strain and pulmonary hypertension (53.9%), pericardial effusion (37.3%), emphysema of the chest wall (12.3%), pneumothorax (11.8%), emphysema of the mediastinum (7.4%), and pulmonary embolism (2.5%). Results of CT scans led to changes in management in 26.5% of cases. Mortality was significantly increased in subjects with involvement of lung parenchyma of >80% (P = .004). Intrahospital transport was associated with critical incidents in 8.3% of cases.CONCLUSIONS: Systematic evaluation of thoracic CT scans yielded information useful for making a diagnosis, predicting prognosis, and recognizing concomitant disorders requiring therapeutic interventions. Results obtained from CT scans led to changes in management in 26.5% of cases.
U2 - 10.4187/respcare.04308
DO - 10.4187/respcare.04308
M3 - SCORING: Journal article
C2 - 26647453
JO - RESP CARE
JF - RESP CARE
SN - 0020-1324
ER -