Imagistic prezentation of adult respiratory distress syndrome

Abstract

Background. Pathogenetically, adult respiratory distress syndrome (ARDS) is a particular form of acute noncardiogenic pulmonary edema produced by acute damage of pulmonary vessels endothelium secondary to advanced inflammatory processes, massive hemorrhage, multisystem failure. Objective(s). Evaluation of the radiologic changes’ characteristic for ARDS. Materials and methods. In the period 2022-2024 we detected 432 cases of ARDS in patients admitted to the intensive care department of IMSP SCR „T. Moșneaga”. The age of the examined patients ranged from 24 to 83 years. The gender composition of the investigated group: 240 males and 192 females. Favorable outcome was reported in 324 of the patients. Results. The radiologic examination in the initial stages of ARDS revealed unchanged dimensions of the cardiac shadow, reticular deformity of the pulmonary pattern, fluid collections in the pleural sinuses, hypervolemic pulmonary hili, vascular pedicle < 48 mm, bilateral peripheral little foci, aired bronchi. We further witnessed an advancement of the pulmonary process up to ARDS stage II-III, which was manifested by progression and fusion of pulmonary infiltrates, appearance of bullae. Stage IV was presented by the development of pneumonic foci and fluid collections in the pleural sinuses, laminar mediastinal emphysema. Conclusion(s). Dynamic chest radiologic examination allows early detection and further evaluation of the ARDS progression. Since the imagistically determined stage of the pathologic process correlates with the risk of death, radiologic examination carries an additional prognostic role to the diagnostic one.