scholarly journals Ultrasound versus Computed Tomography Assessment of Focal Lung Aeration in Invasively Ventilated ICU Patients

2021 ◽  
Author(s):  
Marry R. Smit ◽  
Luigi Pisani ◽  
Eva J.E. de Bock ◽  
Ferdinand van der Heijden ◽  
Frederique Paulus ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Icu Patients ◽  
Lung Aeration

scholarly journals An Experimental Pre-Post Study on the Efficacy of Respiratory Physiotherapy in Severe Critically III COVID-19 Patients

2021 ◽  
Vol 10 (10) ◽  
pp. 2139
Author(s):  
Denise Battaglini ◽  
Salvatore Caiffa ◽  
Giovanni Gasti ◽  
Elena Ciaravolo ◽  
Chiara Robba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Critically Ill ◽  
Lung Ultrasound ◽  
Quantitative Computed Tomography ◽  
Icu Patients ◽  
Lung Aeration ◽  
Before And After ◽  
Respiratory Physiotherapy

Background: Respiratory physiotherapy (RPT) is considered essential in patients’ management during intensive care unit (ICU) stay. The role of RPT in critically ill COVID-19 patients is poorly described. We aimed to investigate the effects of RPT on oxygenation and lung aeration in critically ill COVID-19 patients admitted to the ICU. Methods: Observational pre-post study. Patients with severe COVID-19 admitted to the ICU, who received a protocolized CPT session and for which a pre-and post-RPT lung ultrasound (LUS) was performed, were included. A subgroup of patients had an available quantitative computed tomography (CT) scan performed within 4 days from RPT. The primary aim was to evaluate whether RPT improved oxygenation; secondary aims included correlations between LUS, CT and response to RPT. Results: Twenty patients were included. The median (1st–3rd quartile) PaO2/FiO2 was 181 (105–456), 244 (137–497) and 246 (137–482) at baseline (T0), after RPT (T1), and after 6 h (T2), respectively. PaO2/FiO2 improved throughout the study (p = 0.042); particularly, PaO2/FiO2 improved at T1 in respect to T0 (p = 0.011), remaining higher at T2 (p = 0.007) compared to T0. Correlations between LUS, volume of gas (rho = 0.58, 95%CI 0.05–0.85, p = 0.033) and hyper-aerated mass at CT scan (rho = 0.54, 95% CI 0.00–0.84, p = 0.045) were detected. No significant changes in LUS score were observed before and after RPT. Conclusions: RPT improved oxygenation and the improvement persisted after 6 h. Oxygenation improvement was not reflected by aeration changes assessed with LUS. Further studies are warranted to assess the efficacy of RPT in COVID-19 ICU patients.

Modified pediatric lung ultrasound score compared with computed tomography for assessment of lung aeration in children

2021 ◽  
Vol 87 (6) ◽  
Author(s):  
Oliviero FOCHI ◽  
Alfio BRONCO ◽  
Mirco NACOTI ◽  
Davide SIGNORI ◽  
Stefano GATTI ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Ultrasound ◽  
Lung Aeration ◽  
Ultrasound Score

scholarly journals Intraventricular pressure monitoring in patients with thalamic and ganglionic hemorrhages

2003 ◽  
Vol 61 (2B) ◽  
pp. 376-380 ◽  
Author(s):  
Clement Hamani ◽  
Marcus Vinicius Zanetti ◽  
Fernando Campos Gomes Pinto ◽  
Almir Ferreira Andrade ◽  
Orildo Ciquini Jr ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mass Effect ◽  
Intraventricular Pressure ◽  
Pressure Monitoring ◽  
Ventricular Dilation ◽  
Icu Patients ◽  
Computed Tomography Scans ◽  
Surgical Evacuation ◽  
Eye Opening ◽  
Increased Icp

In the present study, we have evaluated the use of intraventricular pressure catheters in thalamic and ganglionic hemorrhages. Ten patients admitted in our Emergency Department in Glasgow Coma Scale (GCS) equal or below 13 enrolled the study (at least one point should have been lost in the eye opening score to exclude purely aphasic patients that were fully alert). After a complete clinical and neurological evaluation, computed tomography scans were obtained and the volume of the hematomas, as well as presence or absence of hydrocephalus, were considered. Intraventricular pressure catheters connected in parallel to external derivation systems were implanted and patients were thereafter sent to the ICU. Patients that presented mass effect lesions with sustained increased ICP levels or clinical and neurological deterioration were submitted in addition, to the surgical evacuation of the hematomas. Clinical evolution, complications and the rehabilitation of the patients were recorded. Clinical outcome was assessed with the Glasgow Outcome Score. In all but three patients the initial intracranial pressure levels were bellow 20 mmHg (mean for all patients was 14.1 ± 6.5 mmHg). Notwithstanding, these three patients were extremely difficult to treat. For this group of patients mortality was 100%. Among the patients that presented ICP levels bellow 20 mmHg, 04 developed hydrocephalus and 03 did not display ventricular dilation. As expected, the major benefits concerning the intraventricular pressure catheters connected in parallel with external derivation systems were observed in the group of patients that presented ICP levels bellow 20 mmHg and had hydrocephalus. Mild non-statistically significant correlations for all the three groups were achieved either when the initial GCS and ICP levels (r=-0.28, p=0.43) or when ICP levels and the volumes of the hematomas were compared (r=0.38, p=0.28). In addition, no significant correlations were observed concerning the final outcome of the patients and the variables previously evaluated.

scholarly journals Sonographic Bedside Quantification of Pleural Effusion Compared to Computed Tomography Volumetry in ICU Patients

2018 ◽  
Vol 4 (04) ◽  
pp. E131-E135 ◽  
Author(s):  
Ulf Teichgräber ◽  
Judith Hackbarth
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Supine Position ◽  
Cost Effective ◽  
Pleural Effusions ◽  
Icu Patients ◽  
The Us ◽  
Volumetric Estimation ◽  
Scan Data

Abstract To date, the reliability of ultrasound for the quantitative assessment of pleural effusion has been limited. In the following study, an easy and cost-effective bedside ultrasound method was developed and investigated for specific use in the intensive care unit (ICU). 22 patients (median age: 58.5 years, range: 37–88 years, 14 men and 8 women) with a total of 31 pleural effusions were examined in the ICU. The inclusion criterion was complete visualization of the effusion on chest computed tomography (CT). The ultrasound (US) examination was performed less than 6 h after the diagnostic CT scan. The pleural effusion volume was calculated volumetrically from the CT scan data. Within 4.58 +/- 2.87 h after the CT scan, all patients were re-examined with US in the ICU. The fluid crescent's thickness was measured between each intercostal space (ICS) with the patient in a supine position and a 30° inclination of the torso. The US measurements were compared to the calculated CT volumes using regression analysis, resulting in the following formula: V=13.330 x ICS6 (V=volume of the effusion [ml]; ICS6=sonographic measurement of the thickness of the liquid crescent [mm] in the sixth ICS).A significant correlation between the sonographically measured and the CT-calculated volumes was best observed for the sixth ICS (R2=0.589; ICC=0.7469 with p<0.0001 and a 95% CI of 0.5364–0.8705).The sonographic assessment of pleural effusions in a supine position and a 30° inclination of the torso is feasible for the volumetric estimation of pleural effusion. This is especially true for ICU patients with severe primary diseases and orthopnea who are unable to sit upright or lie flat.

Dynamic computed tomography: a novel technique to study lung aeration and atelectasis formation during experimental CPR

Resuscitation ◽  
2002 ◽  
Vol 53 (3) ◽  
pp. 307-313 ◽  
Author(s):  
Klaus Markstaller ◽  
Jens Karmrodt ◽  
Marcus Doebrich ◽  
Benno Wolcke ◽  
Hendrik Gervais ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Dynamic Computed Tomography ◽  
Novel Technique ◽  
Lung Aeration

scholarly journals Ultra-low-dose sequential computed tomography for quantitative lung aeration assessment—a translational study

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Lorenzo Ball ◽  
Anja Braune ◽  
Francesco Corradi ◽  
Claudia Brusasco ◽  
Alessandro Garlaschi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Low Dose ◽  
Translational Study ◽  
Lung Aeration

scholarly journals Semiautomatic segmentation of longitudinal computed tomography images in a rat model of lung injury by surfactant depletion

2015 ◽  
Vol 118 (3) ◽  
pp. 377-385 ◽  
Author(s):  
Yi Xin ◽  
Gang Song ◽  
Maurizio Cereda ◽  
Stephen Kadlecek ◽  
Hooman Hamedani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Segmentation ◽  
Lung Injury ◽  
Transformation Model ◽  
Reference Image ◽  
Quantitative Ct ◽  
Semiautomatic Segmentation ◽  
Computed Tomography Images ◽  
Lung Aeration ◽  
Surfactant Depletion

Quantitative analysis of computed tomography (CT) is essential to the study of acute lung injury. However, quantitative CT is made difficult by poor lung aeration, which complicates the critical step of image segmentation. To overcome this obstacle, this study sought to develop and validate a semiautomated, multilandmark, registration-based scheme for lung segmentation that is effective in conditions of poor aeration. Expiratory and inspiratory CT images were obtained in rats ( n = 8) with surfactant depletion of incremental severity to mimic worsening aeration. Trained operators manually delineated the images to provide a comparative landmark. Semiautomatic segmentation originated from a single, previously segmented reference image obtained at healthy baseline. Deformable registration of the target images (after surfactant depletion) was performed using the symmetric diffeomorphic transformation model with B-spline regularization. Registration used multiple landmarks (i.e., rib cage, spine, and lung parenchyma) to minimize the effect of poor aeration. Then target images were automatically segmented by applying the calculated transformation function to the reference image contour. Semiautomatically and manually segmented contours proved to be highly similar in all aeration conditions, including those characterized by more severe surfactant depletion and expiration. The Dice similarity coefficient was over 0.9 in most conditions, confirming high agreement, irrespective of poor aeration. Furthermore, CT density-based measurements of gas volume, tissue mass, and lung aeration distribution were minimally affected by the method of segmentation. Moving forward, multilandmark registration has the potential to streamline quantitative CT analysis by enabling semiautomatic image segmentation of lungs with a broad range of injury severity.

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