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Imaging of ICU Patients

  • Rahul LohanEmail author
Chapter

Abstract

Imaging in intensive care unit (ICU) is integral to patient management. The portable chest radiograph is the most commonly requested imaging examination in ICU, and, despite its limitations, it significantly contributes to the decision-making process. Multidetector CT (MDCT) is reserved for relatively complex and challenging clinical scenarios. Bedside ultrasound is emerging as a promising imaging modality as it does not subject the patients to risks and resources involved in the transportation of these patients to the CT facility. Ultrasound is an effective modality to triage patients and is being increasingly incorporated into the emergency and intensive care management algorithms.

References

  1. 1.
    Starling EH. On the absorption of fluids from the connective tissue spaces. J Physiol. 1896;19(4):312–26.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Ingram RH Jr, Braunwald E. Dyspnea and pulmonary edema. In: Fauci AS, Braunwald E, Isselbacher KJ, et al., editors. Harrison’s principles of internal medicine. 14th ed. New York, NY: McGraw-Hill; 1998. p. 190–4.Google Scholar
  3. 3.
    Gluecker T, Capasso P, Schnyder P, Gudinchet F, Schaller MD, et al. Clinical and radiologic features of pulmonary edema. Radiographics. 1999;19(6):1507–31.PubMedCrossRefGoogle Scholar
  4. 4.
    Cardinale L, Volpicelli G, Lamorte A, Martino J, Veltri A. Revisiting signs, strengths and weaknesses of standard chest radiography in patients of acute dyspnea in the emergency department. J Thorac Dis. 2012;4(4):398–407.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Bentz MR, Primack SL. Intensive care unit imaging. Clin Chest Med. 2015;36(2):219–34.PubMedCrossRefGoogle Scholar
  6. 6.
    Definition Task Force ARDS. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307(23):2526–33.Google Scholar
  7. 7.
    Desai SR, Wells AU, Suntharalingam G, Rubens MB, Evans TW, Hansell DM. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary injury: a comparative CT study. Radiology. 2001;218(3):689–93.PubMedCrossRefGoogle Scholar
  8. 8.
    Rossi SE, Erasmus JJ, Volpacchio M. “Crazy-paving” pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics. 2003;23:1508–19.CrossRefGoogle Scholar
  9. 9.
    Ichikado K, Suga M, Muranaka H, Gushima Y, Miyakawa H, Tsubamoto M, et al. Prediction of prognosis for acute respiratory distress syndrome with thin-section CT: validation in 44 cases. Radiology. 2006;238(1):321–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Shevland JE, Hirleman MT, Hoang KA, Kealey GP. Lobar collapse in the surgical intensive care unit. Br J Radiol. 1983;56(668):531–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Morehead RS, Pinto SJ. Ventilator-associated pneumonia. Arch Intern Med. 2000;160:1926–36.PubMedCrossRefGoogle Scholar
  12. 12.
    Rubinowitz AN, Siegel MD, Tocino I. Thoracic imaging in ICU. Crit Care Clin. 2007;23(3):539–73.PubMedCrossRefGoogle Scholar
  13. 13.
    Diederich S. Chest CT for suspected pulmonary complications of oncologic therapies: how I review and report. Cancer Imaging. 2016;16:7.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Marom EM, McAdams HP, Erasmus JJ, Goodman PC. The many faces of pulmonary aspiration. AJR Am J Roentgenol. 1999;172(1):121–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Lichtenberger JP, Digumarthy SR, Abbott GF, Shepard JA, Sharma A. Diffuse pulmonary hemorrhage: clues to the diagnosis. Curr Probl Diagn Radiol. 2014;43(3):128–39.PubMedCrossRefGoogle Scholar
  16. 16.
    Kang J, Litmanovich D, Bankier AA, Boiselle PM, Eisenberg RL. Manifestations of systemic diseases on thoracic imaging. Curr Probl Diagn Radiol. 2010;39(6):247–61.PubMedCrossRefGoogle Scholar
  17. 17.
    McLeod AG, Geerts W. Venous thromboembolism prophylaxis in critically ill patients. Crit Care Clin. 2011;27:765–80.PubMedCrossRefGoogle Scholar
  18. 18.
    Cook D, Attia J, Weaver B, McDonald E, Meade M, Crowther M. Venous thromboembolic disease: an observational study in medical-surgical intensive care unit patients. J Crit Care. 2000;15:127–32.PubMedCrossRefGoogle Scholar
  19. 19.
    Westermark N. On the roentgen diagnosis of lung embolism. Acta Radiol. 1938;19:357–72.CrossRefGoogle Scholar
  20. 20.
    Fleischner FG. Roentgen diagnosis of pulmonary embolism. Heart Bull. 1961;10:104–7.PubMedGoogle Scholar
  21. 21.
    Williams JR, Wilcox WC. Pulmonary embolism: roentgenographic and angiographic considerations. AJR Am J Roentgenol. 1963;89:333.Google Scholar
  22. 22.
    Hampton AO, Castleman B. Correlation of postmortem chest teleroentgenograms with autopsy findings with special reference to pulmonary embolism and infarction. AJR Am J Roentgenol. 1940;43:305–26.Google Scholar
  23. 23.
    Gibson N, Sohne M, Buller H. Prognostic value of echocardiography and spiral computed tomography in patients with pulmonary embolism. Curr Opin Pulm Med. 2005;11(5):380–4.PubMedGoogle Scholar
  24. 24.
    Nikolaou K, Thieme S, Sommer W, Johnson T, Reiser MF. Diagnosing pulmonary embolism: new computed tomography applications. J Thorac Imaging. 2010;25(2):151–60.PubMedCrossRefGoogle Scholar
  25. 25.
    Yuan R, Shuman WP, Earls JP, Hague CJ, Mumtaz HA, et al. Reduced iodine load at CT pulmonary angiography with dual-energy monochromatic imaging: comparison with standard CT pulmonary angiography – a prospective randomized trial. Radiology. 2012;262(1):290–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Tocino I, Westcott JL. Barotrauma. Radiol Clin N Am. 1996;34:59–81.PubMedGoogle Scholar
  27. 27.
    Tocino IM, Miller MH, Fairfax WR. Distribution of pneumothorax in the supine and semirecumbent critically ill adult. AJR Am J Roentgenol. 1985;144(5):901–5.PubMedCrossRefGoogle Scholar
  28. 28.
    Zylak CM, Standen JR, Barnes GR, Zylak CJ. Pneumomediastinum revisited. Radiographics. 2000;20:1043–57.PubMedCrossRefGoogle Scholar
  29. 29.
    Muller N. Imaging of the pleura. Radiology. 1993;186:297–309.PubMedCrossRefGoogle Scholar
  30. 30.
    Kuhlman JE, Sinha NK. Complex disease of the pleural space: radiographic and CT evaluation. Radiographics. 1997;17(1):63–79.PubMedCrossRefGoogle Scholar
  31. 31.
    Hallifax RJ, Talwar A, Wrightson JM, Edey A, Gleeson FV. State-of-the-art: radiological investigation of pleural disease. Respir Med. 2017;124:88–99.PubMedCrossRefGoogle Scholar
  32. 32.
    Goodman LR, Conrardy PA, Laing F, Singer MM. Radiographic evaluation of endotracheal tube position. AJR Am J Roentgenol. 1976;127(3):433–4.PubMedCrossRefGoogle Scholar
  33. 33.
    Godoy MC, Leitman BS, de Groot PM, Vlahos I, Naidich DP. Chest radiography in the ICU: part 1, evaluation of airway, enteric, and pleural tubes. AJR Am J Roentgenol. 2012;198(3):563–71.PubMedCrossRefGoogle Scholar
  34. 34.
    Rollins RJ, Tocino I. Early radiographic signs of tracheal rupture. AJR Am J Roentgenol. 1987;148:695–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Godoy MC, Leitman BS, de Groot PM, Vlahos I, Naidich DP. Chest radiography in the ICU: part 2, evaluation of cardiovascular lines and other devices. AJR Am J Roentgenol. 2012;198(3):572–81.PubMedCrossRefGoogle Scholar
  36. 36.
    Marik PE, Zaloga GP. Gastric versus post-pyloric feeding: a systematic review. Crit Care. 2003;7(3):R46–51.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Cadman A, Lawrance JA, Fitzsimmons L, Spencer-Shaw A, Swindell R. To clot or not to clot? That is the question in central venous catheters. Clin Radiol. 2004;59:349–55.PubMedCrossRefGoogle Scholar
  38. 38.
    Kazerooni EA, Gross BH. Lines, tubes, and devices. In: Kazerooni EA, Gross BH, editors. Cardiopulmonary imaging. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 255–93.Google Scholar
  39. 39.
    Stahly TL, Tench WD. Lung entrapment and infarction by chest tube suction. Radiology. 1977;122:307–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Diagnostic RadiologyKhoo Teck Puat HospitalSingaporeSingapore

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