Learning objectives
to acknowledge the importance of this possible fatal condition
to depict its radiological features
to emphasize the role of cross-sectional imaging in understanding ARDS
Background
Acute respiratory distress syndrome (ARDS) is basically a clinical situation suggested by an abrupt-onset dyspnea,
hypoxemia that is refractory to oxygen therapy and diffuse pulmonary infiltrates.
Disorders associated with ARDS ehibit either direct lung injuries (e.g.
drowning,
lung contusion,
pneumonia),
or indirect lung injuries (e.g.
severe trauma,
shock,
sepsis).
The diagnostic criteria are:
acute onset (<7 days)
PaO2/FiO2 < 200 mmHg
diffuse,
bilateral pulmonary infiltrates on frontal radiograph
absence of left atrial hypertension
ARDS has three stages: exudative stage with interstitial edema and hyaline membrane...
Findings and procedure details
Chest radiographs and computed tomography are the imaging techniques of choice.
The first one is primarilyused to support the diagnosis,
to spot the complication and for continuous monitoring; the latter is preferred for a better characterisation of the disease,
its extension and its complications.
Chest radiographs
Chest radiograph findings of ARDS vary widely depending on the stage of the disease.
Diffuse alveolar opacitiespointing out consolidation are counted as the first imagistic result Fig. 1 .
Air bronchogram is visible.
The opacities progress into a more...
Conclusion
ARDS is a clinical syndrome of severe dyspnea with rapid onset,
hypoxemia that is refractory to oxygen therapy and diffuse pulmonary infiltrates.
It has three phases,
each of which has distinct radiographic features.
The imaging palette for ARDS includes chest radiographs and CT scans.
CT scans changed the understanding and the management of ARDS.
References
http://radiopaedia.org/articles/acute-respiratory-distress-syndrome-1
http://eradiology.bidmc.harvard.edu/LearningLab/respiratory/chalupka.pdf
http://emedicine.medscape.com/article/362571-overview#a2
http://radiopaedia.org/cases/congestive-cardiac-failure-1