Larger Pulmonary Contusions Are Risk Factors for ARDS

Classic Article Review   – Background: Pulmonary contusion is seen in acute thoracic trauma. Rapid acceleration-deceleration disrupts pulmonary capillaries, leading to localized edema and parenchymal hemorrhage. On CT, there is a characteristic appearance of mixed focal ground-glass and consolidative opacities sparing the subpleural regions. Pulmonary contusion can progress to acute respiratory distress syndrome (ARDS), which has an in-hospital mortality rate of 40%, and typically develops approximately 72 hours after injury. Degree of lung involvement is correlated to ARDS progression, and rapid automated CT volumetry of pulmonary contusion may predict progression to ARDS and help guide early clinical management. Objective: To train and validate deep learning models to quantify pulmonary contusion as a percentage of total lung volume (automated Lung Contusion Index, or auto-LCI) and assess the relationship between auto-LCI and clinical outcomes. Design: Retrospective study. Met more...