Adult respiratory distress syndrome profiles by computed tomography

TLDR

Computed tomography was performed on ten mechanically ventilated ARDS patients and seven healthy controls at three lung levels (apex, hilum, base), and lung weight was estimated from mean CT‑index values and gas volume assuming the levels represented the whole lung. The dominant CT finding in ARDS was dependent‑region densities, and the CT‑index distribution fell into three patterns: a bimodal type I with a normal‑range mode, a narrow unimodal type II centered on the water CT range, and a broad unimodal type III in the abnormal CT range.

Abstract

Ten patients with full-blown ARDS, on mechanical ventilation with PEEP underwent lung CT. Seven normal subjects were also studied. Three tomographic levels (apex, hilum, and base) were selected. The most consistent morphologic finding in ARDS was he presence of densities in the dependent regions of the lung. Assuming that the three levels were a representative sample of the whole lung, the lung weight was computed from the mean CI number and lung gas volume. Analysis of the CI number frequency distribution revealed three definite patterns of distribution; type I, bimodal, with one mode in the normal CT number range; type 2, unimodal narrow distribution, with the mode in the CT range of water; and type 3, unimodal broad distribution in the abnormal CT number range.