ERS statement on chest imaging in acute respiratory failure

Area of Science:

• Critical care medicine
• Radiology
• Pulmonology

Background:

• Chest imaging is vital for diagnosing and monitoring acute respiratory failure.
• Current recommendations for utilizing diverse imaging modalities are insufficient for critical care physicians.
• Available techniques include X-ray, CT, lung ultrasound, electrical impedance tomography, and PET.

Purpose of the Study:

• To provide a comprehensive clinical review of chest imaging techniques for acute respiratory failure assessment.
• To establish evidence-based recommendations for the indications and limitations of different imaging modalities.
• To guide critical care physicians in selecting appropriate imaging for patient management.

Main Methods:

• Systematic literature search from inception to September 2018.
• Evaluation of 1833 initially identified references, with 135 ultimately included.
• Panel assessment of indications, technical aspects, qualitative/quantitative analysis, and mechanical ventilation interplay for each technique.

Main Results:

• Chest imaging aids in understanding the pathogenesis and pathophysiology of acute respiratory failure.
• Different imaging techniques offer complementary information and have distinct indications.
• The review synthesizes evidence to inform clinical decision-making.

Conclusions:

• Chest imaging techniques are essential for managing acute respiratory failure.
• Standardized guidelines are needed to optimize the use of various imaging modalities.
• This statement provides a framework for evidence-based application of chest imaging in critical care.