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Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318295d0c8
Thoracic Imaging

Computed Tomography Findings in Septic Patients With Acute Respiratory Distress Syndrome: Correlation With Survival and Pulmonary Versus Extrapulmonary Septic Focus

Stelter, Lars MD*; Steffen, Ingo MD*; Pinkernelle, Jens G. MD*; von Dossow-Hanfstingl, Vera MD; Kastrup, Marc MD; Denecke, Timm MD*; Grieser, Christian MD*

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Objective: The objective of this study was to evaluate computed tomography (CT) findings in patients with sepsis with unknown inflammatory focus and acute respiratory distress syndrome.

Methods: Acute respiratory distress syndrome findings on CT of 36 patients with sepsis were graded on a 6-point scale, and the percentage of affected lung was estimated. Resulting CT scores were correlated to intensive care scores and survival.

Results: Forty-four percent of the patients died, revealing a significantly higher CT score than survivors (P = 0.01). Survivors showed larger areas of unaffected lung (P < 0.001), whereas patients with fatal outcome had more ground-glass opacities (P = 0.002; sensitivity, 73%; specificity, 57%) and traction bronchiectasis (P = 0.009; sensitivity, 54%; specificity, 68%). Pulmonary findings on CT did not allow discriminating between a pulmonary and extrapulmonary focus. No significant coherence between CT score and intensive care scores could be revealed.

Conclusions: A CT scoring system based on pulmonary findings in patients with sepsis with acute respiratory distress syndrome comprises prognostic implications in terms of the patients’ survival.

© 2013 by Lippincott Williams & Wilkins



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