PMID: 9172857Mar 1, 1997Paper

The impact of routine chest radiography on ICU management decisions: an observational study

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
P E Marik, M L Janower

Abstract

To document the impact of routine daily chest radiographs on treatment decisions in a medical ICU. The study sample consisted of 200 consecutive patients in an 11-bed medical ICU of a university-affiliated teaching hospital. During the study period, each patient's current and previous chest radiographs were reviewed in the ICU during morning rounds. A computerized digital video display system was used. Changes in therapy made as a consequence of this review were recorded. A total of 471 chest radiographs were reviewed. The patients' mean score on the Acute Physiology and Chronic Health Evaluation II (APACHE II) was 14.6 +/- 2.5, and the mean length of stay in the ICU was 3.6 days +/- 2.1 days (range, 11-24 days). A change in therapy was made on the basis of information obtained from review of the chest radiograph in 174 instances (37% of radiographs). The most frequent therapeutic interventions were use of a loop diuretic to treat pulmonary edema (26%), repositioning of an endotracheal tube (24%), and diagnostic studies to determine the cause of a new pulmonary infiltrate (16%). At least one change in therapy was made for 91 (66%) of the 138 intubated patients but for only 14 (23%) of the 62 nonintubated patients; this differen...Continue Reading

Citations

Jul 20, 2006·BMC Medical Imaging·Marleen E GraatMarcus J Schultz
Apr 11, 2013·Journal of the American College of Radiology : JACR·Judith K AmorosaRakesh D Shah
Sep 18, 2007·Chest·Karin A HendriksePeter E Spronk
Feb 13, 2008·Clinics in Chest Medicine·Joshua R HillSteven L Primack
Jul 18, 2000·The Surgical Clinics of North America·S Y Lee, H L Frankel
May 31, 2015·Clinics in Chest Medicine·Matthew R Bentz, Steven L Primack
Dec 12, 2002·Chest·Alexander G Duarte

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