Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19
Background and Objectives: There are scant data available in the published literature providing chest computed tomography (CT) findings on pulmonary interstitial emphysema (PIE), complications and associated parenchymal abnormalities. We report the incidence of PIE and complications by chest CT in p...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Lung India |
| Subjects: | |
| Online Access: | http://www.lungindia.com/article.asp?issn=0970-2113;year=2022;volume=39;issue=2;spage=174;epage=176;aulast=Scialpi |
| _version_ | 1818906264711725056 |
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| author | Michele Scialpi Giovanni Battista Scalera Alessandro Bellini Andrea Biagelli Marino Chiodi Refky Nicola |
| author_facet | Michele Scialpi Giovanni Battista Scalera Alessandro Bellini Andrea Biagelli Marino Chiodi Refky Nicola |
| author_sort | Michele Scialpi |
| collection | DOAJ |
| description | Background and Objectives: There are scant data available in the published literature providing chest computed tomography (CT) findings on pulmonary interstitial emphysema (PIE), complications and associated parenchymal abnormalities. We report the incidence of PIE and complications by chest CT in patients with COVID-19. Methods: We retrospective analyzed 897 chest CT scans performed with 64-slice CT scanners during the COVID-19 pandemic period from March 2020 to September 2021. Two radiologists and two physicians in training in diagnostic radiology, independently and in consensus, assessed PIE as air within the perilobular (low-attenuation area) and perivascular interstitium such as its complications, parenchymal anomalies and pleural effusion; in addition, the complications of PIE, parenchymal anomalies and pleural effusion were evaluated. Descriptive statistics were used to summarize the data, and the results were expressed as counts and percentages. Results: PIE was revealed in 25 out of 897 patients (2.8%) and associated with pneumomediastinum, subcutaneous emphysema, and pneumothorax in 25 (100%), 16 (64%), and 7 (28%), patients, respectively. Out of 25 patients, 24 patients had ground-glass opacity (GGO), 23 patients had crazy paving, 22 patients had consolidation and 2 patients had pleural effusion. Eighteen out of 25 patients had noninvasive ventilation before CT scan, initially treated with continuous positive airway pressure (positive end expiratory pressure [PEEP] of 10 cmH2O) and subsequently with bilevel positive airway pressure (range PEEP of 8–12 cmH2O). The remaining seven patients had invasive mechanical ventilation via orotracheal intubation (pressure plateau at approximately 25 cmH2O). Six out of 25 (24%) patients died. Conclusion: Chest CT allows the detection of complications associated with PIE and parenchyma abnormalities. The timely detection of PIE and minimal pneumomediastinum could aid the optimization of ventilation modalities and parameters based on patients clinical status therefore potentially reducing complications. |
| first_indexed | 2024-12-19T21:36:28Z |
| format | Article |
| id | doaj.art-f9088dafc6444c5db6a23427a03acbee |
| institution | Directory Open Access Journal |
| issn | 0970-2113 0974-598X |
| language | English |
| last_indexed | 2024-12-19T21:36:28Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj.art-f9088dafc6444c5db6a23427a03acbee2022-12-21T20:04:47ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2022-01-0139217417610.4103/lungindia.lungindia_654_21Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19Michele ScialpiGiovanni Battista ScaleraAlessandro BelliniAndrea BiagelliMarino ChiodiRefky NicolaBackground and Objectives: There are scant data available in the published literature providing chest computed tomography (CT) findings on pulmonary interstitial emphysema (PIE), complications and associated parenchymal abnormalities. We report the incidence of PIE and complications by chest CT in patients with COVID-19. Methods: We retrospective analyzed 897 chest CT scans performed with 64-slice CT scanners during the COVID-19 pandemic period from March 2020 to September 2021. Two radiologists and two physicians in training in diagnostic radiology, independently and in consensus, assessed PIE as air within the perilobular (low-attenuation area) and perivascular interstitium such as its complications, parenchymal anomalies and pleural effusion; in addition, the complications of PIE, parenchymal anomalies and pleural effusion were evaluated. Descriptive statistics were used to summarize the data, and the results were expressed as counts and percentages. Results: PIE was revealed in 25 out of 897 patients (2.8%) and associated with pneumomediastinum, subcutaneous emphysema, and pneumothorax in 25 (100%), 16 (64%), and 7 (28%), patients, respectively. Out of 25 patients, 24 patients had ground-glass opacity (GGO), 23 patients had crazy paving, 22 patients had consolidation and 2 patients had pleural effusion. Eighteen out of 25 patients had noninvasive ventilation before CT scan, initially treated with continuous positive airway pressure (positive end expiratory pressure [PEEP] of 10 cmH2O) and subsequently with bilevel positive airway pressure (range PEEP of 8–12 cmH2O). The remaining seven patients had invasive mechanical ventilation via orotracheal intubation (pressure plateau at approximately 25 cmH2O). Six out of 25 (24%) patients died. Conclusion: Chest CT allows the detection of complications associated with PIE and parenchyma abnormalities. The timely detection of PIE and minimal pneumomediastinum could aid the optimization of ventilation modalities and parameters based on patients clinical status therefore potentially reducing complications.http://www.lungindia.com/article.asp?issn=0970-2113;year=2022;volume=39;issue=2;spage=174;epage=176;aulast=Scialpichest computed tomography (ct)coronavirus disease (covid-19)pulmonary interstitial emphysema (pie)complicationspneumomediastinum |
| spellingShingle | Michele Scialpi Giovanni Battista Scalera Alessandro Bellini Andrea Biagelli Marino Chiodi Refky Nicola Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19 Lung India chest computed tomography (ct) coronavirus disease (covid-19) pulmonary interstitial emphysema (pie) complications pneumomediastinum |
| title | Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19 |
| title_full | Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19 |
| title_fullStr | Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19 |
| title_full_unstemmed | Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19 |
| title_short | Pulmonary interstitial emphysema and complications: incidence and CT findings in COVID-19 |
| title_sort | pulmonary interstitial emphysema and complications incidence and ct findings in covid 19 |
| topic | chest computed tomography (ct) coronavirus disease (covid-19) pulmonary interstitial emphysema (pie) complications pneumomediastinum |
| url | http://www.lungindia.com/article.asp?issn=0970-2113;year=2022;volume=39;issue=2;spage=174;epage=176;aulast=Scialpi |
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