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.
