The Baby Lung Philosophy

  • L. Gattinoni
  • L. Brazzi
  • P. Pelosi
Conference paper


ARDS (Acute Respiratory Distress Syndrome) refers to a generalized inflammation of the lung parenchima, caused by different diseases. However, independently from its specific etiology, ARDS is characterized by diffuse pulmonary infiltrates, decreased respiratory compliance and severe hypoxemia, scarcely responsive to the administration of high inspiratory oxygen concentrations [1]. Moreover, ARDS pathologic characteristics may change during the course of the disease, from edema to fibrosis and disruption of alveolar septa [2]. Computed tomography (CT) has been used, in these last years, for clinical evaluation of different thoracic diseases and has rapidly gained popularity both as a research and diagnostic tool [3]. Moreover, the use of CT has played an important role in improving our knowledge of pathophysiology of ARDS [4–6].


Acute Respiratory Distress Syndrome Acute Respiratory Failure Adult Respiratory Distress Syndrome Compute Tomography Number Linear Attenuation Coefficient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Ashbaugh DG, Bigelow DB, Petty TL et al (1967) Acute respiratory distress in adults. Lancet 2:319–323PubMedCrossRefGoogle Scholar
  2. 2.
    Teplitz C (1976) The core pathobiology and integrated medical science of acute respiratory insufficiency. Surg Clin North Am 56:1091–1130PubMedGoogle Scholar
  3. 3.
    Naidich DP, Webb WR, Muller NL (1993) Thoracic computed tomography: current concepts. In: Potchen EJ, Grainger RG, Greene R (eds) Pulmonary radiology. Saunders Company, Philadelphia, pp 386–404Google Scholar
  4. 4.
    Pelosi P, Crotti S, Brazzi L et al (1996) Computed tomography in adult respiratory distress syndrome: what has it taught us? Eur Respir J 9:1055–1062PubMedCrossRefGoogle Scholar
  5. 5.
    Gattinoni L, Pelosi P (1996) Pathophysiologic insights into acute respiratory failure. Curr Opin Crit Care 2:8–12CrossRefGoogle Scholar
  6. 6.
    Gattinoni L, Pelosi P, Brazzi L (1995) Computed tomography in adult respiratory distress syndrome. Respiratory Therapy 4:79–83Google Scholar
  7. 7.
    Gattinoni L, Pesenti A, Torresin A et al (1986) Adult respiratory distress syndrome profiles by computed tomography. J Thorac Imag 1:25–30CrossRefGoogle Scholar
  8. 8.
    Gattinoni L, Pesenti A, Bombino M et al (1988) Relationship between lung computed tomographic density, gas-exchange and PEEP in acute respiratory failure. Anesthesiology 69: 824–832PubMedCrossRefGoogle Scholar
  9. 9.
    Gattinoni L, Pelosi P, Vitale G et al (1991) Body position changes redistribute lung computed tomographic densities in patients with acute respiratory failure. Anesthesiology 74:15–23PubMedCrossRefGoogle Scholar
  10. 10.
    Brismar B, Hedenstierna G, Lundquist H et al (1985) Pulmonary densities during anesthesia with muscular relaxation. A proposal of atelectasis. Anesthesiology 62:422–428PubMedCrossRefGoogle Scholar
  11. 11.
    Rosenblum LJ, Mauceri RA, Wellenstein DE et al (1980) Density patterns in the normal lung as determined by computed tomography. Radiology 137:409–416PubMedGoogle Scholar
  12. 12.
    Gattinoni L, Pesenti A, Avalli L et al (1987) Pressure-volume curve of total respiratory system in acute respiratory failure. Computed tomographic scan study. Am Rev Respir Dis 136:730–736PubMedCrossRefGoogle Scholar
  13. 13.
    Gattinoni L, Pesenti A (1987) ARDS: the non-homogeneous lung: fact and hypothesis. Intensive and Critical Care Digest 6:1–4Google Scholar
  14. 14.
    Pelosi P, D’Andrea L, Vitale G et al (1994) Vertical gradient of regional lung inflation in adult respiratory distress syndrome. Am Rev Respir Dis 149:8–13CrossRefGoogle Scholar
  15. 15.
    Dantzker DR, Brook LJ, Dehart P et al (1979) Ventilation perfusion distributions in the ARDS. Am Rev Respir Dis 120:1039–1052PubMedGoogle Scholar
  16. 16.
    Gattinoni L, D’Andrea L, Pelosi P et al (1993) Regional effects and mechanism of positive end-expiratory pressure in early adult respiratory distress syndrome. JAMA 269:2122–2127PubMedCrossRefGoogle Scholar
  17. 17.
    Churg A, Golden J, Fligiel S et al (1983) Bronchopulmonary dysplasia in the adult. Am Rev Respir Dis 127:117–120PubMedGoogle Scholar
  18. 18.
    Slavin G, Nunn JF, Crow J et al (1982) Bronchiolectasis: a complication of artificial ventilation. BMJ 28:931–934CrossRefGoogle Scholar
  19. 19.
    Gattinoni L, Bombino M, Pelosi P et al (1994) Lung structure and function in different stages of severe adult respiratory distress syndrome. JAMA 271:1772–1779PubMedCrossRefGoogle Scholar
  20. 20.
    Klose R, Osswald PM (1981) Effects of PEEP on pulmonary mechanics and oxygen transport in the late stages of acute pulmonary failure. Intensive Care Med 7:165–170PubMedCrossRefGoogle Scholar
  21. 21.
    Lemaire F, Harf A, Teisseire BP (1985) Oxygen exchange across the acutely injured lung. In: Zapol WM, Falke K (eds) Acute respiratory failure. Marcel Dekker Inc., New York, pp 521–552Google Scholar
  22. 22.
    Zapol WM, Reid L (1983) The pulmonary vascular lesions of the adult respiratory distress syndrome. Am J Pathol 112:112–126PubMedGoogle Scholar
  23. 23.
    Snow RL, Davies P, Pontoppidan P et al (1982) Pulmonary vascular remodelling in adult respiratory distress syndrome. Am Rev Respir Dis 126:887–892PubMedGoogle Scholar
  24. 24.
    Ryam DW, Pelosi P (1996) The prone position in acute respiratory distress syndrome. BMJ 312:860–861CrossRefGoogle Scholar
  25. 25.
    Gattinoni L, Pelosi P, Pesenti A et al (1991) CT scan in ARDS: clinical and physio-pathological insight. Acta Anaesth Scand 95:87–96CrossRefGoogle Scholar
  26. 26.
    Amato MBP, Barbas CSV, Medeiros DM et al (1995) Beneficial effects of “open lung approach” with low distending pressures in acute respiratory distress syndrome. Am Rev Respir Dis 152:1835–1846CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1997

Authors and Affiliations

  • L. Gattinoni
  • L. Brazzi
  • P. Pelosi

There are no affiliations available

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