Details

Autor(en) / Beteiligte

• Gaulton, Timothy G.
• Xin, Yi
• Victor, Marcus
• Nova, Alice
• Cereda, Maurizio

Titel

Imaging the pulmonary vasculature in acute respiratory distress syndrome

Ist Teil von

• Nitric oxide, 2024-06, Vol.147, p.6-12

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Acute respiratory distress syndrome (ARDS) is characterized by a redistribution of regional lung perfusion that impairs gas exchange. While speculative, experimental evidence suggests that perfusion redistribution may contribute to regional inflammation and modify disease progression. Unfortunately, tools to visualize and quantify lung perfusion in patients with ARDS are lacking. This review explores recent advances in perfusion imaging techniques that aim to understand the pulmonary circulation in ARDS. Dynamic contrast-enhanced computed tomography captures first-pass kinetics of intravenously injected dye during continuous scan acquisitions. Different contrast characteristics and kinetic modeling have improved its topographic measurement of pulmonary perfusion with high spatial and temporal resolution. Dual-energy computed tomography can map the pulmonary blood volume of the whole lung with limited radiation exposure, enabling its application in clinical research. Electrical impedance tomography can obtain serial topographic assessments of perfusion at the bedside in response to treatments such as inhaled nitric oxide and prone position. Ongoing technological improvements and emerging techniques will enhance lung perfusion imaging and aid its incorporation into the care of patients with ARDS. •Pulmonary perfusion in ARDS is highly variable and difficult to predict using existing clinical metrics.•Pulmonary perfusion impacts gas exchange and may modulate ARDS progression.•Several modalities exist to image and measure pulmonary perfusion in experimental and clinical ARDS.•Defining perfusion patterns using imaging will help advance precision medicine in ARDS.