Gattinoni L, Mascheroni D, Torresin A, Marcolin R, Fumagalli R, Vesconi S, Rossi G P, Rossi F, Baglioni S, Bassi F
Intensive Care Med. 1986;12(3):137-42. doi: 10.1007/BF00254928.
Ten patients with acute respiratory failure (ARF), (4 pneumonia, 4 sepsis, 2 polytrauma), underwent computerized tomography (CT) of the lungs, (apex, hilum, base), at 5, 10, 15 cm H2O positive end expiratory pressure (PEEP). The ARF lungs, on CT scan, appeared as a patchwork of normal and dense areas with generally well defined boundaries. Most of the densities were found in the dependent regions. The areas of density were correlated with PaO2 (r = 0.51). The PEEP increase resulted in a significant expansion of total cross-sectional lung surface area. The dense areas decreased significantly at the hilum and base when increasing PEEP while the changes at the apex were not significant. The changes of density with PEEP were highly correlated with the changes in oxygenation (r = 0.91). In the individual patient, however, the modifications of gas exchange can not be entirely predicted from morphological changes, possibly due to a diversion of pulmonary blood flow.
10例急性呼吸衰竭（ARF）患者（4例肺炎、4例脓毒症、2例多发伤），在呼气末正压（PEEP）为5、10、15 cmH₂O时接受了肺部（肺尖、肺门、肺底）的计算机断层扫描（CT）。在CT扫描中，ARF患者的肺部表现为正常区域和致密区域的拼凑，边界通常清晰。大多数致密区域位于下垂部位。密度区域与动脉血氧分压（PaO₂）相关（r = 0.51）。PEEP增加导致肺总横截面积显著扩大。增加PEEP时，肺门和肺底的致密区域显著减少，而肺尖的变化不显著。密度随PEEP的变化与氧合变化高度相关（r = 0.91）。然而，在个体患者中，气体交换的改变不能完全从形态学变化中预测，这可能是由于肺血流分流所致。
