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Diagnostics
Special Issues
Critical Care Imaging—2nd Edition
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Critical Care Imaging—2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 7089

Special Issue Editors

Dr. Denise Battaglini

E-Mail Website
Guest Editor
Anesthesia and Critical Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
Interests: brain-lung crosstalk; ARDS; respiratory physiotherapy; tracheostomy/airways; microbiota
Special Issues, Collections and Topics in MDPI journals
Dr. Davide Orlandi

E-Mail Website
Guest Editor
Department of Radiology, Ospedale Evangelico Internazionale, Genoa, Italy
Interests: diagnostics; CT scan; ultrasound; computed tomography; respiratory imaging; magnetic resonance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the last decade, radiologists and intensive care physicians have collaborated to improve fast imaging acquisition, early diagnosis, and standardized imaging findings in order to provide several hints that may facilitate clinicians in interpreting imaging findings and easily managing patients. Given the time constraints and patients with limited ability to cooperate, bedside radiologic evaluation in intensive care often cannot be as comprehensive and optimal as in the radiology department. However, diagnostic imaging techniques and their interpretation (including ultrasound, computed tomography and magnetic resonance) have become essential to guide intensive care daily practice and patients’ management, and the ability to interpret critical care images is becoming even more essential to help clinicians in handling emergency situations and making confident decisions.

The purpose of this Special Issue is to highlight novelties in diagnostic medical imaging, including the research that is being carried out to improve radiological assessment and diagnostic approaches in critical care medicine.

Dr. Denise Battaglini
Dr. Davide Orlandi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • computed tomography
  • intensive care images
  • critical care ultrasound
  • magnetic resonance

Published Papers (5 papers)

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Research

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11 pages, 1315 KiB  
Article
Lung Ultrasound to Determine the Effect of Lower vs. Higher PEEP on Lung Aeration in Patients without ARDS—A Substudy of a Randomized Clinical Trial
by Claudio Zimatore, Anna Geke Algera, Michela Botta, Charalampos Pierrakos, Ary Serpa Neto, Salvatore Grasso, Marcus J. Schultz, Luigi Pisani, Frederique Paulus and on behalf of the RELAx–Investigators
Diagnostics 2023, 13(12), 1989; https://doi.org/10.3390/diagnostics13121989 - 07 Jun 2023
Cited by 1 | Viewed by 1011
Abstract
Background: Ventilation with lower positive end–expiratory pressure (PEEP) may cause loss of lung aeration in critically ill invasively ventilated patients. This study investigated whether a systematic lung ultrasound (LUS) scoring system can detect such changes in lung aeration in a study comparing lower [...] Read more.
Background: Ventilation with lower positive end–expiratory pressure (PEEP) may cause loss of lung aeration in critically ill invasively ventilated patients. This study investigated whether a systematic lung ultrasound (LUS) scoring system can detect such changes in lung aeration in a study comparing lower versus higher PEEP in invasively ventilated patients without acute respiratory distress syndrome (ARDS). Methods: Single center substudy of a national, multicenter, randomized clinical trial comparing lower versus higher PEEP ventilation strategy. Fifty–seven patients underwent a systematic 12–region LUS examination within 12 h and between 24 to 48 h after start of invasive ventilation, according to randomization. The primary endpoint was a change in the global LUS aeration score, where a higher value indicates a greater impairment in lung aeration. Results: Thirty–three and twenty–four patients received ventilation with lower PEEP (median PEEP 1 (0–5) cm H2O) or higher PEEP (median PEEP 8 (8–8) cm H2O), respectively. Median global LUS aeration scores within 12 h and between 24 and 48 h were 8 (4 to 14) and 9 (4 to 12) (difference 1 (–2 to 3)) in the lower PEEP group, and 7 (2–11) and 6 (1–12) (difference 0 (–2 to 3)) in the higher PEEP group. Neither differences in changes over time nor differences in absolute scores reached statistical significance. Conclusions: In this substudy of a randomized clinical trial comparing lower PEEP versus higher PEEP in patients without ARDS, LUS was unable to detect changes in lung aeration. Full article
(This article belongs to the Special Issue Critical Care Imaging—2nd Edition)
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10 pages, 933 KiB  
Article
Bronchoscopy Findings during Percutaneous Dilation Tracheostomy: A Single Tertiary Medical Center Experience
by Ko-Wei Chang and Hsin-Yueh Fang
Diagnostics 2023, 13(10), 1764; https://doi.org/10.3390/diagnostics13101764 - 17 May 2023
Viewed by 916
Abstract
Percutaneous dilation tracheostomy (PDT) is a common procedure in intensive care units. Bronchoscopy has been recommended to guide PDT to decrease complication rates, but no study has analyzed bronchoscopy outcomes during PDT. In this retrospective study, we analyzed bronchoscopy findings and clinical outcomes [...] Read more.
Percutaneous dilation tracheostomy (PDT) is a common procedure in intensive care units. Bronchoscopy has been recommended to guide PDT to decrease complication rates, but no study has analyzed bronchoscopy outcomes during PDT. In this retrospective study, we analyzed bronchoscopy findings and clinical outcomes during PDT. We collected data on all patients who underwent PDT between May 2018 and February 2021. All PDT operations were guided by bronchoscopy, and we assessed the airway to the third order of the bronchi. Forty-one patients who underwent PDT were included in this study. The average duration of PDT was 102.8 ± 34.6 s, and the average duration of bronchoscopy was 49.8 ± 43.8 s. No complications related to bronchoscopy and no significant changes in gas exchange or ventilator parameters were noted after the procedure. Fifteen patients (36.6%) exhibited abnormal bronchoscopy findings, including two patients (13.3%) with intra-airway mass lesions and obvious airway obstruction. None of the patients with intra-airway masses could be liberated from mechanical ventilation. This study observed a non-negligibly high incidence of unexpected endotracheal or endobronchial masses in patients with chronic respiratory failure during PDT, and a high rate of weaning failure was noted in these patients. The completion of bronchoscopy during PDT may provide additional clinical benefits. Full article
(This article belongs to the Special Issue Critical Care Imaging—2nd Edition)
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Review

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19 pages, 3620 KiB  
Review
The Role of Ultrasonography in the Process of Weaning from Mechanical Ventilation in Critically Ill Patients
by Lou’i Al-Husinat, Basil Jouryyeh, Ahlam Rawashdeh, Chiara Robba, Pedro Leme Silva, Patricia Rieken Macedo Rocco and Denise Battaglini
Diagnostics 2024, 14(4), 398; https://doi.org/10.3390/diagnostics14040398 - 12 Feb 2024
Viewed by 2823
Abstract
Weaning patients from mechanical ventilation (MV) is a complex process that may result in either success or failure. The use of ultrasound at the bedside to assess organs may help to identify the underlying mechanisms that could lead to weaning failure and enable [...] Read more.
Weaning patients from mechanical ventilation (MV) is a complex process that may result in either success or failure. The use of ultrasound at the bedside to assess organs may help to identify the underlying mechanisms that could lead to weaning failure and enable proactive measures to minimize extubation failure. Moreover, ultrasound could be used to accurately identify pulmonary diseases, which may be responsive to respiratory physiotherapy, as well as monitor the effectiveness of physiotherapists’ interventions. This article provides a comprehensive review of the role of ultrasonography during the weaning process in critically ill patients. Full article
(This article belongs to the Special Issue Critical Care Imaging—2nd Edition)
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Other

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4 pages, 2954 KiB  
Interesting Images
Rapidly Progressive Idiopathic Pulmonary Arterial Hypertension in a Paediatric Patient Treated with Lung Transplantation
by Filip Baszkowski, Weronika Pelczar-Płachta, Nikola Pempera, Sylwia Sławek-Szmyt, Marta Kałużna-Oleksy, Maciej Lesiak and Waldemar Bobkowski
Diagnostics 2023, 13(20), 3185; https://doi.org/10.3390/diagnostics13203185 - 12 Oct 2023
Viewed by 832
Abstract
Pulmonary arterial hypertension (PAH) is a rare heterogeneous disorder in the paediatric population which is mostly associated with congenital heart disease. The management of paediatric idiopathic PAH (IPAH) is difficult due to insufficient comparative data and depends on the results of evidence-based adult [...] Read more.
Pulmonary arterial hypertension (PAH) is a rare heterogeneous disorder in the paediatric population which is mostly associated with congenital heart disease. The management of paediatric idiopathic PAH (IPAH) is difficult due to insufficient comparative data and depends on the results of evidence-based adult studies with several pulmonary vasodilators, as well as the clinical experiences of paediatric experts. Our aim was to present the case of a 9-year-old girl who underwent several methods of treatment, including pharmacotherapy with a significant reaction to treprostinil, as well as bilateral lung transplantation. The patient’s treatment was distinguished by the fact that the dose escalation was as rapid as that observed in the adult population. Due to the limited current evidence and knowledge, the initiation of treatment for these patients remains an individual choice. On the grounds of the number of non-specific symptoms, the diagnosis of this patient was a long process and based mainly on the differential diagnosis. The purpose of this paper is to study this example in order to highlight the importance of early symptoms and the quick implementation of intensive treatment. The applied methods may be useful in doubtful diagnosis processes and treatment procedures in the paediatric population. Full article
(This article belongs to the Special Issue Critical Care Imaging—2nd Edition)
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7 pages, 1757 KiB  
Interesting Images
Chronic or Changeable Infarct Size after Spontaneous Coronary Artery Dissection
by Gordana Krljanac, Svetlana Apostolovic, Zlatko Mehmedbegovic, Olga Nedeljkovic-Arsenovic, Ruzica Maksimovic, Ivan Ilic, Aleksandra Djokovic, Lidija Savic, Ratko Lasica and Milika Asanin
Diagnostics 2023, 13(9), 1518; https://doi.org/10.3390/diagnostics13091518 - 23 Apr 2023
Cited by 3 | Viewed by 1151
Abstract
Spontaneous coronary artery dissection (SCAD) could be the cause of acute myocardial infarction (AMI) and sudden cardiac death. Clinical presentations can vary considerably, but the most common is the elevation of cardiac biomarkers associated with chest discomfort. Different pathological etiology in comparison with [...] Read more.
Spontaneous coronary artery dissection (SCAD) could be the cause of acute myocardial infarction (AMI) and sudden cardiac death. Clinical presentations can vary considerably, but the most common is the elevation of cardiac biomarkers associated with chest discomfort. Different pathological etiology in comparison with Type 1 AMI is the underlying infarct size in this population. A 42-year-old previously healthy woman presented with SCAD. Detailed diagnostical processing and treatment which were performed could not prevent myocardial injury. The catheterization laboratory was the initial place for the establishment of a diagnosis and proper management. The management process can be very fast and sometimes additional imaging methods are necessary. Finding predictors of SCAD recurrence is challenging, as well as predictors of the resulting infarct scar size. Patients with recurrent clinical symptoms of chest pain, ST elevation, and complication represent a special group of interest. Therapeutic approaches for SCAD range from the ”watch and wait” method to complete revascularization with the implantation of one or more stents or aortocoronary bypass grafting. The infarct size could be balanced through the correct therapeutical approach, and, proper multimodality imaging would be helpful in the assessment of infarct size. Full article
(This article belongs to the Special Issue Critical Care Imaging—2nd Edition)
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