Lung Disease in the ICU: A Difficult Diagnostic Challenge

  • L. R. Goodman


Determining the cause of lung disease in the critically ill is often a frustrating task. Numerous primary diseases may affect the lung and systemic disorder (e.g. sepsis, ARDS) may affect the lung independently or may superimpose on a preexisting lung disorder. Evaluation is also made more difficult by various therapeutic maneuvers (e.g. artificial ventilation, tracheal bronchial toilet) which alter the appearance of the radiograph. Despite these problems, an understanding of both the timing, radiographic appearance, and progression of these lesions is extremely helpful in sorting out the various etiologies. A constant dialogue between the radiologist and clinical team is required to maximize information and minimize the number of imaging procedures (1).


Pulmonary Insufficiency Maxillary Sinusitis Aspiration Pneumonitis Parenchymal Consolidation Frustrate Task 
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.
    Goodman LR, Putman C (eds) (1992) Critical care imaging, 3rd edn. Saunders, PhiladelphiaGoogle Scholar
  2. 2.
    Wandtke JC (1994) Bedside chest radiography. Radiology 190:1PubMedGoogle Scholar
  3. 3.
    Bartlett JG, Gorbach SL (1975) The triple threat of aspiration pneumonia. Chest 68:560–566PubMedCrossRefGoogle Scholar
  4. 4.
    Shifrin R, Choplin R (1996) Aspiration in patients in critical care units. In: Goodman LR, Kuzo RS (eds). Radiol Clin North Am (in press)Google Scholar
  5. 5.
    Holzapfel L, Chevret S, Madinier G, Ohen F, Demingeon G, Coupry A, Chaudet M (1993) Influence of long-term oro- or nasotracheal intubation on nosocomial maxillary sinusitis and pneumonia: results of a prospective, randomized, clinical trial. Crit Care Med 21(8): 1132–1138PubMedCrossRefGoogle Scholar
  6. 6.
    Elpem H, Jacobs ER, Bone RC (1987) Incidence of aspiration in tracheally intubated adults. Heart Lung 26:527–531Google Scholar
  7. 7.
    Lefcoe MS, Fox GA, Leasa DJ et al (1994) Accuracy of portable chest radiography in the critical care setting: diagnosis of pneumonia based on quantitative cultures obtained from protected brush catheter. Radiology 192:882Google Scholar
  8. 8.
    Pingleton S (1988) Complications of acute respiratory failure. Am Rev Resp Dis 137: 1463–1493PubMedGoogle Scholar
  9. 9.
    Winer-Muram HT, Rubin SA, Ellis JV, Jennings SG, Arheart KL, Wunderink RG, Leeper KV, Meduri GU (1993) Pneumonia and ARDS in patients receiving mechanical ventilation: diagnostic accuracy of chest radiography. Radiology 188:479PubMedGoogle Scholar
  10. 10.
    Morgan PW, Goodman LR (1991) Pulmonary edema and adult respiratory distress syndrome. In: Müller NL (ed). Radiol Clin North Am 29(5):943–963Google Scholar
  11. 11.
    Tocino I, Westcott, J (1996) Barotrauma. In: Goodman LR, Kuzo RS (eds). Radiol Clin North Am (in press)Google Scholar
  12. 12.
    Beres RA, Goodman LR (1993) Pneumothorax: detection with upright versus decubitus radiography. Radiology 186:19–26PubMedGoogle Scholar
  13. 13.
    Ruskin JA, Gumey JW, Thorsen MK, Goodman LR (1987) Detection of pleural effusions on supine chest radiographs. AJR 148:681–683PubMedGoogle Scholar

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© Springer-Verlag Italia, Milano 1996

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  • L. R. Goodman

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