ERS statement on chest imaging in acute respiratory failure.

Chest imaging in patients with acute respiratory failure plays an important role in diagnosing, monitoring and assessing the underlying disease. The available modalities range from plain chest X-ray to computed tomography, lung ultrasound, electrical impedance tomography and positron emission tomography. Surprisingly, there are presently no clear-cut recommendations for critical care physicians regarding indications for and limitations of these different techniques.The purpose of the present European Respiratory Society (ERS) statement is to provide physicians with a comprehensive clinical review of chest imaging techniques for the assessment of patients with acute respiratory failure, based on the scientific evidence as identified by systematic searches. For each of these imaging techniques, the panel evaluated the following items: possible indications, technical aspects, qualitative and quantitative analysis of lung morphology and the potential interplay with mechanical ventilation. A systematic search of the literature was performed from inception to September 2018. A first search provided 1833 references. After evaluating the full text and discussion among the committee, 135 references were used to prepare the current statement.These chest imaging techniques allow a better assessment and understanding of the pathogenesis and pathophysiology of patients with acute respiratory failure, but have different indications and can provide additional information to each other.
Competing Interests: Conflict of interest: D. Chiumello has nothing to disclose. Conflict of interest: G.F. Sferrazza Papa has nothing to disclose. Conflict of interest: A. Artigas reports grants from Grifols, Fisher & Paykel, Fundacion Areces and Instituto Carlos III, outside the submitted work. Conflict of interest: B. Bouhemad has nothing to disclose. Conflict of interest: A. Grgic reports personal fees from MSD, Boehringer Ingelheim, Roche and Bayer Vital, outside the submitted work. Conflict of interest: L. Heunks reports personal fees for travel and lecturing from Maquet critical care, and grants from Ventfree and Orionpharma, outside the submitted work. Conflict of interest: K. Markstaller has nothing to disclose. Conflict of interest: G.M. Pellegrino has nothing to disclose. Conflict of interest: L. Pisani has nothing to disclose. Conflict of interest: D. Rigau works as a methodologist for the ERS. Conflict of interest: M.J. Schultz has nothing to disclose. Conflict of interest: G. Sotgiu has nothing to disclose. Conflict of interest: P. Spieth has nothing to disclose. Conflict of interest: M. Zompatori has nothing to disclose. Conflict of interest: P. Navalesi has nothing to disclose.
(Copyright ©ERS 2019.)