Assessment of PEEP-induced reopening of collapsed lung regions in acute lung injury: are one or three CT sections representative of the entire lung?
Intensive Care Med
; 27(9): 1504-10, 2001 Sep.
Article
em En
| MEDLINE
| ID: mdl-11685344
ABSTRACT
OBJECTIVES:
To study whether PEEP-induced reopening of collapsed lung regions--defined as the decrease in nonaerated lung volume measured on a single or three computerized tomographic (CT) sections--is representative of the decrease in overall nonaerated lung volume.DESIGN:
Review of 39 CT scans obtained in consecutive patients with Acute Lung Injury. SETTINGS Fourteen-bed surgical intensive care unit of a University Hospital. MEASUREMENTS ANDRESULTS:
PEEP-induced decrease in nonaerated lung volume was measured in 39 patients with ALI on a single juxtadiaphragmatic CT section, on three CT sections--apical, hilar, and juxtadiaphragmatic--and on contiguous apex-to-diaphragm CT sections. The percentage of decrease in nonaerated lung volume following PEEP, was compared between one, three and all CT sections using a linear regression analysis and Bland and Altman's method. The decrease in nonaerated lung volume measured on a single and three CT sections was significantly correlated with the decrease in nonaerated lung volume measured on all CT sections R=0.83, P<0.0001 for one CT section and R=0.92, P<0.0001 for three CT sections. However, measurements performed on a single CT section were poorly representative of the overall lung bias -6%, limits of agreement ranging between -37% and +25%. Measurements performed on three CT sections overestimated by 11% the overall decrease in nonaerated lung volume bias -11%, limits of agreement ranging between -29% and +7%.CONCLUSIONS:
PEEP-induced reopening of collapsed lung regions measured on a single or three CT sections sensibly differs from the reopening of collapsed lung regions measured on the overall lung. The inhomogeneous distribution of PEEP-induced reopening of collapsed lung regions along the cephalocaudal axis probably explains these discrepancies.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Tomografia Computadorizada por Raios X
/
Respiração com Pressão Positiva
/
Medidas de Volume Pulmonar
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Intensive Care Med
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
França