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The aim of this study was to evaluate the appearance, extent, and distribution of parenchymal changes in the lung after acute respiratory distress syndrome (ARDS) as a function of disease severity and therapeutic procedures. High-resolution computed tomography (HRCT), clinical examination, and lung function tests were performed in 15 patients, 6-10 months after ARDS. The appearance and extent of parenchymal changes were compared with the severity of ARDS, as well as with clinical and therapeutic data. Lung parenchymal changes resembling those found in the presence of pulmonary fibrosis were observed in 13 of 15 patients (87%). The changes were significantly more frequent and more pronounced in the ventral than in the dorsal portions of the lung ( p<0.01). A significant correlation was observed between the extent of lung alterations and the severity of ARDS ( p<0.01), and the duration in which patients had received mechanical ventilation either with a peak inspiratory pressure greater than 30 mmHg ( p<0.05), or with more than 70% oxygen ( p<0.01). Acute respiratory distress syndrome frequently is followed by fibrotic changes in lung parenchyma. The predominantly ventral distribution of these changes indicates that they may be caused by the ventilation regimen and the oxygen therapy rather than by the ARDS. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate equipment availability and current diagnostic strategies for suspected pulmonary embolism (PE) in Austrian hospitals. A questionnaire was sent to the medical directors of all Austrian hospitals with emergency and/or surgical, orthopedic, and medical departments. The questionnaire contained questions regarding the available equipment suitable for the imaging diagnosis of PE, the first-line and second-line imaging tests for patients with suspected PE, and additional lower extremity venous imaging and laboratory tests that complement the diagnostic armamentarium. The return rate for questionnaires was 81% (127 of 157 hospitals). There were 97% of hospitals that had the equipment to perform sonography, 59% could perform pulmonary angiography, 54% spiral CT, 19% ventilation/perfusion (V/P) scintigraphy, and 4% perfusion scintigraphy alone. Spiral-CT angiography (SCTA) was the first-line imaging study for suspected PE in 56% of hospitals, followed by echocardiography and V/P scintigraphy. Lower extremity venous imaging (47%) and, interestingly, V/P scintigraphy (43%), served as second-line imaging tests. D-dimer tests were included in the diagnostic strategy in 74% of hospitals. Spiral-CT angiography is the most commonly used primary method for suspected PE in Austrian hospitals. The V/P scintigraphy is available only in a minority of hospitals to investigate patients with suspected PE. When V/P scintigraphy is available, however, it is employed in a large number of patients per annum. [ABSTRACT FROM AUTHOR]