A radiological visual scale to predict the potentially recruitable lung in ALI/ARDS patients
Conference Poster
Publication Date:
2011
Citation:
A radiological visual scale to predict the potentially recruitable lung
in ALI/ARDS patients / D. Chiumello, M. Cressoni Mainoni, A. Marino, E. Gallazzi, M. Brioni, M.C. Andrisani, M. Lazzerini, P. Biondetti. - In: CRITICAL CARE. - ISSN 1466-609X. - 15:Sup 1(2011), pp. S72-S72. ((Intervento presentato al 31. convegno 31st International Symposium on Intensive Care
and Emergency Medicine tenutosi a Brussels nel 2011 [10.1186/cc9625].
abstract:
Introduction In ALI/ARDS patients the amount of potentially
recruitable lung is extremely variable and it is poorly predictable by
the changes of oxygenation, carbon dioxide or compliance during a
PEEP trial [1]. At the present time the gold standard to compute the
lung recruitability is the quantitative lung CT scan, in which each lung image, after being manually drawn, is analyzed by dedicated software.
However, this is both a laborious and time-consuming technique. The
aim of this study was to evaluate the ability of a visual radiological scale
compared with lung CT scan analysis to predict the lung recruitability
in ALI/ARDS patients.
Methods A whole lung CT scan was performed at 5 and 45 cmH2O
airway pressure. For CT scan analysis each lung image was manually
outlined and analyzed by a dedicated software. The potentially
recruitable lung was defi ned as the proportion of the nonaerated
lung tissue in which aeration was restored [1]. For radiological visual
scale analysis, two radiologists performed a blinded evaluation of the
consolidation/collapsed areas in each lobe by visual inspection [2]. The
overall lung change in consolidation/collapsed was obtained by the
sum of each lobe and computed as the diff erence between the two
conditions.
Results Twenty-four ALI/ARDS patients (age 59 ± 15 years, BMI
26 ± 4 kg/m2, PaO2/FiO2 170 ± 60, PEEP 10 ± 2 cmH2O) were enrolled.
The percentage of potentially recruitable lung was 16.2 ± 7.1% and
14.7 ± 7.0%, computed by CT scan and by the visual radiological scale,
respectively. The mean diff erence between CT scan analysis and visual
radiological analysis was 3.3 ± 4.6% (median: 2.91, interquartile range:
0.38 to 6.56). The error of the visual method was lower than 5% in 14
patients (58.3%), between 5% and 10% in eight patients (33.3%) and
between 10% and 15% in two patients (8.3%).
Conclusions The application of a radiological visual scale is able to
predict the amount of potentially recruitable lung similarly to those
obtained by a dedicated software avoiding the need of manually
drawing each lung image.
References
1. Gattinoni L, et al.: N Engl J Med 2006, 354:1775-1786.
2. Pierce RJ, et al.: Thorax 1980, 35:773-780.
recruitable lung is extremely variable and it is poorly predictable by
the changes of oxygenation, carbon dioxide or compliance during a
PEEP trial [1]. At the present time the gold standard to compute the
lung recruitability is the quantitative lung CT scan, in which each lung image, after being manually drawn, is analyzed by dedicated software.
However, this is both a laborious and time-consuming technique. The
aim of this study was to evaluate the ability of a visual radiological scale
compared with lung CT scan analysis to predict the lung recruitability
in ALI/ARDS patients.
Methods A whole lung CT scan was performed at 5 and 45 cmH2O
airway pressure. For CT scan analysis each lung image was manually
outlined and analyzed by a dedicated software. The potentially
recruitable lung was defi ned as the proportion of the nonaerated
lung tissue in which aeration was restored [1]. For radiological visual
scale analysis, two radiologists performed a blinded evaluation of the
consolidation/collapsed areas in each lobe by visual inspection [2]. The
overall lung change in consolidation/collapsed was obtained by the
sum of each lobe and computed as the diff erence between the two
conditions.
Results Twenty-four ALI/ARDS patients (age 59 ± 15 years, BMI
26 ± 4 kg/m2, PaO2/FiO2 170 ± 60, PEEP 10 ± 2 cmH2O) were enrolled.
The percentage of potentially recruitable lung was 16.2 ± 7.1% and
14.7 ± 7.0%, computed by CT scan and by the visual radiological scale,
respectively. The mean diff erence between CT scan analysis and visual
radiological analysis was 3.3 ± 4.6% (median: 2.91, interquartile range:
0.38 to 6.56). The error of the visual method was lower than 5% in 14
patients (58.3%), between 5% and 10% in eight patients (33.3%) and
between 10% and 15% in two patients (8.3%).
Conclusions The application of a radiological visual scale is able to
predict the amount of potentially recruitable lung similarly to those
obtained by a dedicated software avoiding the need of manually
drawing each lung image.
References
1. Gattinoni L, et al.: N Engl J Med 2006, 354:1775-1786.
2. Pierce RJ, et al.: Thorax 1980, 35:773-780.
IRIS type:
01 - Articolo su periodico
List of contributors:
D. Chiumello, M. Cressoni Mainoni, A. Marino, E. Gallazzi, M. Brioni, M.C. Andrisani, M. Lazzerini, P. Biondetti
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