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DOI: 10.47026/2413-4864-2025-2-1-13
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UDC: 616.24-073.756.8
BBC: 54.12:53.6

Bormyshev A.V., Morozova T.G.

Th role of criteria for early diagnosis and progression of acute pulmonary injury syndrome in intensive care unit patients according to multispiral computed tomography

Keywords: computed tomography, acute pulmonary injury syndrome, prognosis, pulmonary tissue density maps, quantitative indicator

In modern medical practice, multispiral computed tomography is the most informative and preferred method of diagnosing acute respiratory distress syndrome in adult patients. The purpose of the study is to determine the role of criteria for early diagnosis and progression of acute pulmonary injury syndrome in intensive care unit patients according to multispiral computed tomography. Materials and methods of the study. 83 patients who were admitted to the intensive care unit of the Regional State Funded Healthcare Facility «Clinical Hospital № 1» (Smolensk) were examined; 63 patients (93.1%) remained under follow-up for two and a half years. All patients from the main group underwent multispiral computed tomography of the chest organs with additional analysis of pulmonary tissue density. According to computed tomography data, densitometric indicators of possible damage to life support systems were also evaluated: the liver, the brain, kidneys. 39 patients in the main group underwent chest X-ray examination. The values of laboratory parameters of all patients were analyzed: partial pressure of carbon dioxide in the arterial blood, oxygenation index. Research results. In 61 patients (73.5%) with an acute pulmonary injury syndrome index of less than 26% and normal laboratory and radiation criteria, the stay in the intensive care unit ranged from 3 to 5 days, followed by transfer to an in-patient department, and the rehabilitation period reached 3 months. In case of decreased densitometric parameters of internal organs upon admission and in dynamic follow–up, the reverse dynamics was noted in 22 (26.5%), the quantitative criterion of acute pulmonary injury syndrome was more than 26%, the number of inpatient days was from 7 to 11 days, their rehabilitation process lasted more than 6-9 months, in 7 (31.8%) of them there was fatal outcome. Timely adjusted therapeutic and diagnostic measures in 15 patients (68.2%) contributed to the improvement of the clinical and laboratory presentation. Conclusions. The risk of developing acute pulmonary injury syndrome and its unfavorable course should be considered with a quantitative criterion according to pulmonary tissue density maps of more than 26%. Decreased densitometric parameters of internal organs (the liver, the brain, kidneys) upon admission and under dynamic follow-up, the quantitative criterion of acute pulmonary injury syndrome of more than 26% indicate an unfavorable course of nosological forms in patients of the intensive care unit. Multispiral computed tomography of the chest organs has the greatest diagnostic and prognostic significance (AUC ROC – 0.992, 95% CI – 0.890–0.995), along with this additional use of density maps increases the significance of the method upon admission (AUC ROC – 0.995, 95% CI – 0.992–0.997) and dynamic follow-up (AUC ROC – 0.997, 95% CI – 0.994–0.999).

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About authors

Bormyshev Aleksey V.
Post-Graduate Student, Department of Radiation Diagnostics and Radiation Therapy with a course of Additional Professional Education, Smolensk State Medical University, Russia, Smolensk (aleksei-bormyshev@mail.ru; ORCID: https://orcid.org/0009-0008-5934-1332)
Morozova Tatiana G.
Doctor of Medical Sciences, Head of the Department of Radiation Diagnostics and Radiation Therapy with a course of Additional Professional Education, Smolensk State Medical University, Russia, Smolensk (t.g.morozova@yandex.ru; ORCID: https://orcid.org/0000-0003-4983-5300)

Article link

Bormyshev A.V., Morozova T.G. The role of criteria for early diagnosis and progression of acute pulmonary injury syndrome in intensive care unit patients according to multispiral computed tomography [Electronic resource] // Acta medica Eurasica. – 2025. – №2. P. 1-13. – URL: https://acta-medica-eurasica.ru/en/single/2025/2/1/. DOI: 10.47026/2413-4864-2025-2-1-13.

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