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Open Access 01-02-2011 | Research

Computed tomographic assessment of lung weights in trauma patients with early posttraumatic lung dysfunction

Authors: Andreas W Reske, Alexander P Reske, Till Heine, Peter M Spieth, Anna Rau, Matthias Seiwerts, Harald Busse, Udo Gottschaldt, Dierk Schreiter, Silvia Born, Marcelo Gama de Abreu, Christoph Josten, Hermann Wrigge, Marcelo BP Amato

Published in: Critical Care | Issue 1/2011

Abstract

Introduction

Quantitative computed tomography (qCT)-based assessment of total lung weight (M_lung) has the potential to differentiate atelectasis from consolidation and could thus provide valuable information for managing trauma patients fulfilling commonly used criteria for acute lung injury (ALI). We hypothesized that qCT would identify atelectasis as a frequent mimic of early posttraumatic ALI.

Methods

In this prospective observational study, M_lung was calculated by qCT in 78 mechanically ventilated trauma patients fulfilling the ALI criteria at admission. A reference interval for M_lung was derived from 74 trauma patients with morphologically and functionally normal lungs (reference). Results are given as medians with interquartile ranges.

Results

The ratio of arterial partial pressure of oxygen to the fraction of inspired oxygen was 560 (506 to 616) mmHg in reference patients and 169 (95 to 240) mmHg in ALI patients. The median reference M_lung value was 885 (771 to 973) g, and the reference interval for M_lung was 584 to 1164 g, which matched that of previous reports. Despite the significantly greater median M_lung value (1088 (862 to 1,342) g) in the ALI group, 46 (59%) ALI patients had M_lung values within the reference interval and thus most likely had atelectasis. In only 17 patients (22%), M_lung was increased to the range previously reported for ALI patients and compatible with lung consolidation. Statistically significant differences between atelectasis and consolidation patients were found for age, Lung Injury Score, Glasgow Coma Scale score, total lung volume, mass of the nonaerated lung compartment, ventilator-free days and intensive care unit-free days.

Conclusions

Atelectasis is a frequent cause of early posttraumatic lung dysfunction. Differentiation between atelectasis and consolidation from other causes of lung damage by using qCT may help to identify patients who could benefit from management strategies such as damage control surgery and lung-protective mechanical ventilation that focus on the prevention of pulmonary complications.

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Title: Computed tomographic assessment of lung weights in trauma patients with early posttraumatic lung dysfunction
Authors: Andreas W Reske
Alexander P Reske
Till Heine
Peter M Spieth
Anna Rau
Matthias Seiwerts
Harald Busse
Udo Gottschaldt
Dierk Schreiter
Silvia Born
Marcelo Gama de Abreu
Christoph Josten
Hermann Wrigge
Marcelo BP Amato
Publication date: 01-02-2011
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2011
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc10060

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Computed tomographic assessment of lung weights in trauma patients with early posttraumatic lung dysfunction

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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