Early chest computed tomography in adult acute severe community-acquired pneumonia patients treated in the intensive care unit
| Autor: | Lauri Ahvenjärvi, E. Rauvala, Jaana Karhu, Hannu Syrjälä, Tero Ala-Kokko, Pasi Ohtonen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiography Computed tomography Atelectasis 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine Community-acquired pneumonia law medicine Humans Aged medicine.diagnostic_test business.industry General Medicine Pneumonia Middle Aged medicine.disease Intensive care unit respiratory tract diseases Community-Acquired Infections Intensive Care Units Anesthesiology and Pain Medicine 030228 respiratory system Concomitant Female Radiography Thoracic Radiology business Chest radiograph Tomography X-Ray Computed |
| Zdroj: | Acta anaesthesiologica Scandinavica. 60(8) |
| ISSN: | 1399-6576 |
| Popis: | Background The value of early chest computed tomography (CT) was evaluated among severe community-acquired pneumonia (SCAP) patients. Methods The study population consisted of 65 of 457 SCAP patients with concomitant chest CT and radiograph performed within 48 h of ICU admission. Each image pair was re-evaluated by two radiologists. The type of pneumonia, the presence of pleural fluid and atelectasis were assessed. Therapeutic and diagnostic procedures induced by CT results were analysed together with clinical, microbiological and outcome data. Results Alveolar pneumonia was observed in 72.3% of patients by radiograph and in 75.4% of patients by CT. Pleural fluid was detected via chest radiograph and CT in 17 (26.2%) and 41 cases (63.1%), (P < 0.001) and atelectasis in 10 (15.4%) and 22 cases (33.8%), (P = 0.002), respectively. In 34 patients (52.3%), the CT revealed 38 new findings (58.5%) not shown in plain chest radiograph. Out of these 34 patients, therapeutic interventions or procedures were performed in 26 (76.5%). The number of infected lobes correlated negatively with the lowest PaO2/FiO2 ratio (ρ = −0.326, P = 0.008) for chest CT scans. Conclusion Compared with chest radiograph, chest CT generated new findings in nearly 60% of SCAP patients, leading to new procedures or changes in medical treatment in nearly 75% of those patients. Chest CT better describes the pulmonary involvement and severity of oxygenation disorder compared to a plain chest radiograph. |
| Databáze: | OpenAIRE |
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