The radiological diagnosis of shock lung (author's transl)

Abstract

So-called "shock lung" has typical pathological findings; radiologically it is characterised at first by interstitial, late by alveolar pulmonary oedema. This has been shown by a number of case reports. In addition to shock, however, certain intoxications and all forms of left heart failure produce the radiological changes of pulmonary oedema. Transient hyperhydration of the lungs following infusion therapy causes signs of pulmonary oedema which disappear as soon as the fluid balance becomes normal. The radiographic findings of pulmonary oedema correlate well with the intensity and extent of the pathological changes. The radiologist is therefore in a position to evaluate the severity of the shock lung; this is a valuable addition to the clinical findings and the results of physiological tests and blood gas analysis. It has to be emphasised that the radiological changes appear at an early stage, in any case much sooner than the clinical features. Radiological findings may be present without abnormalities on oscultation or percussion. Radiographs of the lungs are therefore indicated in all patients who may be subject to shock lung, particularly if they suffer from undiagnosed hyperventilation.