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05.05.2016 | Chest | Ausgabe 1/2017

European Radiology 1/2017

Humidifier disinfectant-associated lung injury in adults: Prognostic factors in predicting short-term outcome

Zeitschrift:
European Radiology > Ausgabe 1/2017
Autoren:
Hyun Jung Koo, Kyung-Hyun Do, Eun Jin Chae, Hwa Jung Kim, Joon Seon Song, Se Jin Jang, Sang-Bum Hong, Jin Won Huh, En Lee, Soo-Jong Hong
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00330-016-4367-6) contains supplementary material, which is available to authorized users.

Abstract

Objectives

To identify clinical and radiologic findings that affect disease severity and short-term prognosis of humidifier disinfectant-associated lung injury in adults and to compare computed tomography (CT) findings between the patients with and without death or lung transplantation.

Methods

Fifty-nine adults (mean age, 34 years; M/F = 12:47) were enrolled in this retrospective study. Medical records and prospective surveillance data were used to assess clinical and radiological factors associated with a poor clinical outcome. Multivariate generalized estimating equation models were used to analyse serial CT findings. Overall cumulative major events including lung transplantation and mortality were assessed using the Kaplan–Meier method.

Results

Almost half needed ICU admission (47.5 %) and 17 died (28.8 %). Young age, peripartum and low O2 saturation were factors associated with ICU admission. On initial chest radiographs, consolidation (P < 0.001) and ground-glass opacity (P = 0.01) were significantly noted in patients who required ICU admission. CT findings including consolidation (odds ratio (OR), 1.02), pneumomediastinum (OR, 1.66) and pulmonary interstitial emphysema (OR, 1.61) were the risk factors for lung transplantation and mortality.

Conclusion

Clinical and radiologic findings are related to the risks of lung transplantation and mortality of humidifier disinfectant-associated lung injury. Consolidation, pneumomediastinum and pulmonary interstitial emphysema were short-term prognostic CT findings.

Key Points

Young age, peripartum and low O 2 saturation were associated with ICU admission.
Consolidation, pneumomediastinum and pulmonary interstitial emphysema were short-term prognostic CT findings.
Consolidation and ground-glass opacity disappeared within 3 months and replaced by centrilobular nodules.
Radiologic findings are related to the outcome of humidifier disinfectant-associated lung injury.

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