A quantitative CT parameter for the assessment of pulmonary oedema in patients with acute respiratory distress syndrome.
Adult
Aged
Feasibility Studies
Female
Hospital Mortality
Humans
Intensive Care Units
/ statistics & numerical data
Lung
/ diagnostic imaging
Lung Volume Measurements
/ methods
Male
Middle Aged
Pulmonary Edema
/ diagnosis
Respiratory Distress Syndrome
/ complications
Respiratory Function Tests
Severity of Illness Index
Tomography, X-Ray Computed
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
08
03
2020
accepted:
17
10
2020
entrez:
12
11
2020
pubmed:
13
11
2020
medline:
29
12
2020
Statut:
epublish
Résumé
The aim of this study was to establish quantitative CT (qCT) parameters for pathophysiological understanding and clinical use in patients with acute respiratory distress syndrome (ARDS). The most promising parameter is introduced. 28 intubated patients with ARDS obtained a conventional CT scan in end-expiratory breathhold within the first 48 hours after admission to intensive care unit (ICU). Following manual segmentation, 137 volume- and lung weight-associated qCT parameters were correlated with 71 clinical parameters such as blood gases, applied ventilation pressures, pulse contour cardiac output measurements and established status and prognosis scores (SOFA, SAPS II). Of all examined qCT parameters, excess lung weight (ELW), i.e. the difference between a patient's current lung weight and the virtual lung weight of a healthy person at the same height, displayed the most significant results. ELW correlated significantly with the amount of inflated lung tissue [%] (p<0.0001; r = -0.66) and was closely associated with the amount of extravascular lung water (EVLW) (p<0.0001; r = 0.72). More substantially than the oxygenation index (PaO2/FiO2) or any other clinical parameter it correlated with the patients' mean SOFA- (p<0.0001, r = 0.69) and SAPS II-Score (p = 0.0005, r = 0.62). Patients who did not survive intensive care treatment displayed higher values of ELW in the initial CT scans. ELW could serve as a non-invasive method to quantify the amount of pulmonary oedema. It might serve as an early radiological marker of severity in patients with ARDS.
Identifiants
pubmed: 33180805
doi: 10.1371/journal.pone.0241590
pii: PONE-D-20-06745
pmc: PMC7660563
doi:
Types de publication
Journal Article
Observational Study
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0241590Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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