| Assessment of PEEP-induced reopening of collapsed lung regions in acute lung injury: are one or three CT sections representative of the entire lung? | |
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MedLine Citation:
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PMID: 11685344 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To study whether PEEP-induced reopening of collapsed lung regions--defined as the decrease in nonaerated lung volume measured on a single or three computerized tomographic (CT) sections--is representative of the decrease in overall nonaerated lung volume. DESIGN: Review of 39 CT scans obtained in consecutive patients with Acute Lung Injury. Settings: Fourteen-bed surgical intensive care unit of a University Hospital. MEASUREMENTS AND RESULTS: PEEP-induced decrease in nonaerated lung volume was measured in 39 patients with ALI on a single juxtadiaphragmatic CT section, on three CT sections--apical, hilar, and juxtadiaphragmatic--and on contiguous apex-to-diaphragm CT sections. The percentage of decrease in nonaerated lung volume following PEEP, was compared between one, three and all CT sections using a linear regression analysis and Bland and Altman's method. The decrease in nonaerated lung volume measured on a single and three CT sections was significantly correlated with the decrease in nonaerated lung volume measured on all CT sections: R=0.83, P<0.0001 for one CT section and R=0.92, P<0.0001 for three CT sections. However, measurements performed on a single CT section were poorly representative of the overall lung: bias -6%, limits of agreement ranging between -37% and +25%. Measurements performed on three CT sections overestimated by 11% the overall decrease in nonaerated lung volume: bias -11%, limits of agreement ranging between -29% and +7%. CONCLUSIONS: PEEP-induced reopening of collapsed lung regions measured on a single or three CT sections sensibly differs from the reopening of collapsed lung regions measured on the overall lung. The inhomogeneous distribution of PEEP-induced reopening of collapsed lung regions along the cephalocaudal axis probably explains these discrepancies. |
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Authors:
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Q Lu; L M Malbouisson; E Mourgeon; I Goldstein; P Coriat; J J Rouby |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies |
Journal Detail:
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Title: Intensive care medicine Volume: 27 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2001 Sep |
Date Detail:
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Created Date: 2001-10-30 Completed Date: 2001-12-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1504-10 Citation Subset: IM |
Affiliation:
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Réanimation Chirurgicale Pierre Viars, Department of Anesthesiology, La Pitié-Salpêtrière Hospital, 47-83, Boulevard de l'Hôpital, 75013 Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Bias (Epidemiology) Confounding Factors (Epidemiology) Female Hospital Mortality Humans Linear Models Lung Compliance Lung Volume Measurements* Male Middle Aged Positive-Pressure Respiration / methods* Pulmonary Circulation Pulmonary Ventilation Respiratory Distress Syndrome, Adult / classification, mortality, radiography*, therapy* Retrospective Studies Sensitivity and Specificity Severity of Illness Index Tomography, X-Ray Computed / methods*, standards* Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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