The Role of CT-scan Studies for the Diagnosis and Therapy of Acute Respiratory Distress Syndrome
Section snippets
Quantitative analysis of CT scanning
Because the authors believe that the quantitative analysis of CT scanning is of paramount importance for ARDS diagnosis and for a rational setting of mechanical ventilation, a brief description of the technique and its limits is necessary. (A more detailed description of the quantitative analysis may be found elsewhere [7], [8]).
CT scanning and diagnosis of acute respiratory distress syndrome
Since its original description by Ashbaugh and colleagues [1], several clinical definitions of ARDS have been proposed. The key endeavor, always, has been to find clinical and easily measurable signs that could identify the primarily pathologic characteristics of ARDS (ie, the high-permeability inflammatory noncardiogenic lung edema). The symptoms identified originally by Ashbaugh and colleagues were hypoxemia refractory to increased inspired fraction of oxygen (Fio2), bilateral pulmonary
CT scanning and therapy for acute respiratory distress syndrome
The therapy for ARDS is multifactorial, because it includes the specific therapy for the injury leading to ARDS, possible interventions in some of the molecular pathways leading to the widespread inflammation or coagulation abnormalities (eg, steroids, activated protein C), and, finally, supportive therapy, which primarily includes respiratory support with mechanical ventilation. The authors believe that CT scanning is an essential tool for the assessment of some of the effects that mechanical
Summary
The authors have investigated ARDS using CT scanning for more than 20 years. The unique ability of CT scanning to provide a quantitative approach to observing the lung parenchyma has made it possible to understand better the pathophysiology of ARDS. The authors believe that today CT scanning, in addition to its use in research, may be an essential tool allowing a rational setting of mechanical ventilation in patients who have ARDS. The assessment of lung recruitability should guide a correct
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