PMID: 8986482Dec 1, 1996Paper

Routine daily chest radiography is not indicated for ventilated patients in a surgical ICU

Intensive Care Medicine
S Bhagwanjee, D J Muckart

Abstract

To determine a) if clinical examination can accurately predict radiological change and b) if routine chest radiography is efficacious. All mechanically ventilated patients admitted to the Surgical Intensive Care Unit over a 4-week period were enrolled into the study. A physical examination was undertaken by two clinicians to predict significant (radiographic features which alter management) and insignificant (radiographic features which do not alter management) changes. The radiographs were then reviewed by a radiologist who noted any changes from previous radiographs. The clinical findings were then correlated with the radiographical findings. The study was conducted in a 16-bedded Surgical Intensive Care Unit which admits approximately 800 patients per year. The majority of these patients require mechanical ventilation. All patients who required mechanical ventilation were included. Thirty-four patients were studied. The patients were young adults admitted primarily following trauma with a low incidence of pre-existing disease. There were no interventions in this study. One hundred sixty-four radiographs were evaluated. Both examiners were efficient in predicting significant changes (sensitivity of 93 and 97%), but less effic...Continue Reading

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