Preservation of normal lung regions in the adult respiratory distress syndrome

Journal Article · Fri May 09 04:00:00 EDT 1986 · JAMA, J. Am. Med. Assoc.; (United States)

DOI:https://doi.org/10.1001/jama.1986.03370180089038· OSTI ID:6906541

Maunder, R J; Shuman, W P; McHugh, J W; Marglin, S I; Butler, J

In this report, the authors challenge the commonly held assumption that the adult respiratory distress syndrome (ARDS) is a homogeneous process associated with generalized and relatively uniform damage to the alveolar capillary membrane. They studied 13 patients with ARDS, comparing the pulmonary parenchymal changes seen by standard bedside chest roentgenograms with those seen by computed tomography of the chest. Three patients demonstrated generalized lung involvement by both radiologic techniques. In another eight patients, despite the appearance of generalized involvement on the standard chest x-ray film, the computed tomographic scans showed patchy infiltrates interspersed with areas of normal-appearing lung. Two patients showed patchy involvement by both techniques. The fact that ARDS spares some regions of lung parenchyma is useful knowledge in understanding the gas-exchange abnormalities of ARDS, the variable responsiveness to positive end-expiratory pressure, and the occurrence of oxygen toxicity. The problem of regional inhomogeneity should also be kept in mind when interpreting lung biopsy specimens or bronchoalveolar lavage fluid in patients with ARDS.

• Research Organization: Univ. of Washington, Seattle
• OSTI ID: 6906541
• Journal Information: JAMA, J. Am. Med. Assoc.; (United States), Journal Name: JAMA, J. Am. Med. Assoc.; (United States) Vol. 255:18; ISSN JAMAA
• Country of Publication: United States
• Language: English

Related Subjects

550602* -- Medicine-- External Radiation in Diagnostics-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BODY
COMPARATIVE EVALUATIONS
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
HISTOLOGY
LUNGS
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
RADIOLOGY
RESPIRATORY SYSTEM
RESPIRATORY SYSTEM DISEASES
TOMOGRAPHY