Acute Respiratory Distress Syndrome: CT Abnormalities at Long-term Follow-up

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Abstract
To document abnormalities at computed tomography (CT) in adult survivors of acute respiratory distress syndrome (ARDS), to determine the relationships between CT patients during the acute phase and at follow-up, and to assess the effects of mechanical ventilation on the development of CT abnormalities. Thin-section CT scans were obtained during the acute illness and at follow-up in 27 patients with ARDS. The extent and distribution of individual CT patterns were independently analyzed. At follow-up CT, a reticular pattern was the most prevalent (23 patients [85%]) and extensive CT abnormality, with a striking anterior distribution (more anterior distribution than posterior distribution, P < .001). A reticular pattern at follow-up was inversely correlated with the extent of intense parenchymal opacification on scans obtained during the acute illness (Spearman r = -0.26; P < .001). The extent of a reticular pattern at follow-up CT was independently related to the total duration of mechanical ventilation (P = .02) but was most strongly related to the duration of pressure-controlled inverse-ratio ventilation (P < .001). A reticular pattern, with a striking anterior distribution, is a frequent finding of follow-up CT in ARDS survivors and is most strongly related to the duration of pressure-controlled inverse-ratio ventilation.