Education  |   September 2019
Imaging the Injured Lung: Mechanisms of Action and Clinical Use
Author Notes
  • From the Department of Anesthesiology and Critical Care and the Department of Radiology (M.C., Y.X., R.R.R.), University of Pennsylvania, Philadelphia, Pennsylvania; the Interdepartmental Division of Critical Care Medicine and Department of Medicine (A.G.) and Hospital for Sick Children (B.P.K., T.Y.), University of Toronto, Toronto, Ontario, Canada; the Departments of Anesthesia and Biomedical Engineering (J.H.) and Anesthesia, Radiology, and Biomedical Engineering (D.W.K.), University of Iowa, Iowa City, Iowa; and the Hedenstierna Laboratory and Uppsala University Hospital, Uppsala University, Uppsala, Sweden (G.P.).
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • For a downloadable PPT slide containing this article’s citation information, please visit https://anesthesiology.pubs.asahq.org/ss/downloadable_slide.aspx.
    For a downloadable PPT slide containing this article’s citation information, please visit https://anesthesiology.pubs.asahq.org/ss/downloadable_slide.aspx.×
  • Submitted for publication July 13, 2018. Accepted for publication November 9, 2018. Corrected on May 14, 2019.
    Submitted for publication July 13, 2018. Accepted for publication November 9, 2018. Corrected on May 14, 2019.×
  • Address correspondence to Dr. Cereda: Perelman School of Medicine at the University of Pennsylvania, Dulles 773, 3400 Spruce Street, Philadelphia, Pennsylvania 19104-4283. maurizio.cereda@uphs.upenn.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Review Article / Critical Care / Radiological and Other Imaging / Respiratory System / Technology / Equipment / Monitoring
Education   |   September 2019
Imaging the Injured Lung: Mechanisms of Action and Clinical Use
Anesthesiology 9 2019, Vol.131, 716-749. doi:https://doi.org/10.1097/ALN.0000000000002583
Anesthesiology 9 2019, Vol.131, 716-749. doi:https://doi.org/10.1097/ALN.0000000000002583
Abstract

Acute respiratory distress syndrome (ARDS) consists of acute hypoxemic respiratory failure characterized by massive and heterogeneously distributed loss of lung aeration caused by diffuse inflammation and edema present in interstitial and alveolar spaces. It is defined by consensus criteria, which include diffuse infiltrates on chest imaging—either plain radiography or computed tomography. This review will summarize how imaging sciences can inform modern respiratory management of ARDS and continue to increase the understanding of the acutely injured lung. This review also describes newer imaging methodologies that are likely to inform future clinical decision-making and potentially improve outcome. For each imaging modality, this review systematically describes the underlying principles, technology involved, measurements obtained, insights gained by the technique, emerging approaches, limitations, and future developments. Finally, integrated approaches are considered whereby multimodal imaging may impact management of ARDS.