THE INTERRELATIONS OF RADIOLOGIC FINDINGS AND MECHANICAL VENTILATION AND ADMISSION TO INTENSIVE CARE UNIT IN PNEUMONIA PATIENTS IN DAMASCUS HOSPITAL

Rufida Eldebuch, Jemma Alsamman* and PhD. Hussam Al-Bardan

ABSTRACT

Background: Chest X-rays (X-Ray) and Computed Tomography (CT) scans are essential tools for diagnosing lung disease in critically ill patients admitted to intensive care units. These studies provide valuable information about the type and severity of lung injury. One of the most common findings in these examinations is consolidation, which appears as areas filled with fluid or pus instead of the normal air-filled alveoli in the lungs. The size and distribution of these consolidations can vary. In bronchopneumonia, a common pattern seen in ICU patients, multiple lobes of the lungs are often affected. In contrast, lobar pneumonia appears more localized, affecting an entire lobe. As the infection progresses and lung damage worsens, ICU patients may exhibit additional distinctive findings. Pleural effusion, which is accumulation of fluid between the lung and chest wall, and may restrict lung expansion. In some cases, CT scans may reveal air pockets within lung tissues, a condition known as cavitation. While specific radiographic features can help identify the causative agent of pneumonia, these common abnormalities—consolidations, pleural effusion, and cavitation—are often the first indicators alerting doctors to the presence of critical pulmonary infection that requires intensive treatment. Methods: This retrospective cohort study included cases of pneumonia reviewed in Damascus hospital in Damascus, Syria. Samples were collected from patient records in the Pulmonary Internal Medicine Department. The Chi-Square test was used to assess whether there was a relationship between radiological findings and clinical outcomes. Relative Risk (RR) was calculated for statistically significant variables. Results: Among 205 pneumonia cases, the ICU admission rate was 29.8%, while the mechanical ventilation rate was 14.1%. Consolidation was the most common radiological finding on simple chest radiography, observed in half of the cases. Only 26 patients underwent CT scanning, with consolidation being the most common finding (69.2%), followed by ground-glass opacity (23.1%). Half of the cases showed bilateral injury. Among ICU-admitted patients, 68.9% had bilateral injury on simple chest radiography. Among ICU-admitted patients who underwent CT scanning, ground-glass opacity was diagnosed in more than half, with a statistically significant relationship (P<0.05). Additionally, most of them had bilateral injury on CT scan (58.7%) with a statistically significant relationship (P<0.05). Among mechanically ventilated patients who underwent CT scanning, three-quarters (75%) had ground-glass opacity, with a statistically significant relationship (P<0.05). Conclusion: The results of this study reveal potential associations between radiological findings on simple chest radiography and CT scan and the need for ICU admission and mechanical ventilation in pneumonia patients. Further studies are needed to support and generalize these findings.

Keywords: Radiography, Thoracic, Pneumoniae, Imaging, Critical care.