0
Correspondence |

Posterior Consolidation: An Important Clue for Differentiating ARDS From Cardiogenic Pulmonary Edema FREE TO VIEW

Li-Ta Keng, MD
Author and Funding Information

FINANCIAL/NONFINANCIAL DISCLOSURES: None declared.

CORRESPONDENCE TO: Li-Ta Keng, MD, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, No. 25, Ln 442, Sec 1, Jingguo Rd, Hsinchu City 30059, Taiwan


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4):1108-1109. doi:10.1016/j.chest.2015.10.083
Text Size: A A A
Published online

I read with interest the study by Sekiguchi et al in a recent issue of CHEST (October 2015) that focused on combined cardiac and lung ultrasound to evaluate the etiology of acute hypoxic respiratory failure. The authors reported good diagnostic utility in differentiating ARDS from cardiogenic pulmonary edema (CPE) by evaluating the amount of left pleural effusion, the severity of left ventricular dysfunction, and the diameter of the inferior vena cava. In the Supplemental Materials section of the online article, the authors describe that both C (consolidative)-pattern and pleural effusion were assessed in examination point 5 (posterolateral zone of the lung), but only data regarding pleural effusion were reported in e-Table 1. Whether posterior consolidation exists may be important in differentiating ARDS from CPE. Copetti et al identified consolidation by using lung ultrasound in 83% of patients with ARDS but in no patients with CPE. In contrast, posterior consolidation and/or atelectasis have been known to be a classic finding in ARDS, documented by using CT scan results. In a study evaluating lung ultrasound for the assessment of lung recruitment in patients with ARDS, Bouhemad et al also reported that consolidation was the predominant ultrasound pattern in the lower part of the posterior thoracic region. Could Sekiguchi et al provide the detailed information about the ultrasound pattern in examination point 5, especially the consolidation pattern?

References

Sekiguchi H. .Schenck L.A. .Horie R. .et al Critical care ultrasonography differentiates ARDS, pulmonary edema, and other causes in the early course of acute hypoxemic respiratory failure. Chest. 2015;148:912-918 [PubMed]journal. [CrossRef] [PubMed]
 
Copetti R. .Soldati G. .Copetti P. . Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome. Cardiovasc Ultrasound. 2008;6:16- [PubMed]journal. [CrossRef] [PubMed]
 
Gattinoni L. .Caironi P. .Cressoni M. .et al Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med. 2006;354:1775-1786 [PubMed]journal. [CrossRef] [PubMed]
 
Bouhemad B. .Brisson H. .Le-Guen M. .Arbelot C. .Lu Q. .Rouby J.J. . Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med. 2011;183:341-347 [PubMed]journal. [CrossRef] [PubMed]
 

Figures

Tables

References

Sekiguchi H. .Schenck L.A. .Horie R. .et al Critical care ultrasonography differentiates ARDS, pulmonary edema, and other causes in the early course of acute hypoxemic respiratory failure. Chest. 2015;148:912-918 [PubMed]journal. [CrossRef] [PubMed]
 
Copetti R. .Soldati G. .Copetti P. . Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome. Cardiovasc Ultrasound. 2008;6:16- [PubMed]journal. [CrossRef] [PubMed]
 
Gattinoni L. .Caironi P. .Cressoni M. .et al Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med. 2006;354:1775-1786 [PubMed]journal. [CrossRef] [PubMed]
 
Bouhemad B. .Brisson H. .Le-Guen M. .Arbelot C. .Lu Q. .Rouby J.J. . Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med. 2011;183:341-347 [PubMed]journal. [CrossRef] [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543