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Original article| Volume 21, ISSUE 2, P90-103, March 1997

Chest radiography in the ICU

DOI:https://doi.org/10.1016/0899-7071(95)00097-6
Chest radiography in the ICU
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      Abstract

      Proper positioning and assessment of abnormalities and complications of the above-mentioned devices have a significant impact on the management of critically ill patients in the intensive care unit (ICU). The timely assessment of new or rapidly evolving findings is critical. Optimal radiographic technique, availability of images to the clinicians, and rapid reporting by the radiologist all serve to maximize the efficacy of bedside chest radiography in the ICU. Sometimes, changes in cardiopulmonary status may only be appreciated on chest radiographs (CXRs). Complications from ventilatory assistance, such as barotrauma, occur frequently and must be detected promptly. The position of monitoring devices, an important component of critical care management, is best checked radiographically. Indications for CXRs and the recommended frequency for repeat follow-up CXRs are based on the existing literature and the consensus of an expert panel formed by the American College of Radiology.

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      References

      1. ACR panel.
        in: American College of Radiology Thoracic Expert Panel Report. 1996
        • Henschke CI
        • Pasternack GS
        • Schroeder S
        • et al.
        Bedside chest radiography: diagnostic efficacy.
        Radiology. 1983; 149: 23-26
        • Silverstein DS
        • Livingston DH
        • Elcavage J
        • et al.
        The utility of routine daily chest radiography in the surgical intensive care unit.
        J Trauma. 1993; 35: 643-646
        • Bekemeyer WB
        • Crapo RD
        • Calhoon S
        • et al.
        Efficacy of chest radiography in a respiratory intensive care unit.
        Chest. 1985; 88: 691-696
        • Greenbaum DM
        • Marshall KE
        The value of routine daily chest x-rays in intubated patients in the medical intensive care unit.
        Crit Care Med. 1982; 10: 29-30
        • Strain DS
        • Kinasewitz GT
        • Vereen LE
        • George RB
        Value of routine daily chest x-rays in the medical intensive care unit.
        Crit Care Med. 1985; 13: 534-636
        • Hall JB
        • White SR
        • Karrison T
        Efficacy of daily routine chest radiographs in intubated, mechanically ventilated patients.
        Crit Care Med. 1991; 19: 689-693
        • Janower ML
        • Jennas-Nocera A
        • Markai J
        Utility and efficacy of portable chest radiographs.
        AJR. 1984; 142: 265-267
        • Niklason LT
        • Chan HP
        • Cascade PW
        • et al.
        Portable chest imaging: comparison of strange phosphor digital, asymmetric screen film and conventional screen-films systems.
        Radiology. 1993; 186: 387-393
        • MacMahon H
        • Vyborny C
        Technical advances in chest radiography.
        AJR. 1994; 163: 1049-1059
        • Moller A
        Radiography transculcitam: technique and devices to simplify bedside radiography.
        Radiology. 1991; 179: 283-284
        • Boles JM
        • Boussert F
        • Monens JJP
        • et al.
        Measurement of irradiation doses secondary to bedside radiographs in a medical intensive care unit.
        Intensive Care Med. 1987; 13: 60-63
        • Herman MW
        • Patrick J
        • Tabrisky J
        A comparative study of scattered radiation levels from 80 kVp and 240 kVp x-rays in the surgical intensive care unit.
        Radiology. 1980; 137: 552-553
        • Sagel SS
        • Jost RG
        • Glazer HS
        • et al.
        Digital mobile radiography.
        J Thorac Imaging. 1990; 5: 36-48
        • Wandtke JC
        Bedside chest radiograph.
        Radiology. 1994; 190: 1-10
        • Tocino I
        Chest radiography in the critically ill patient.
        in: Greene R Muhm JR Syllabus: A Diagnostic Categorical Course in Chest Radiology. Radiological Society of North America, Oak Brook, IL1992: 311-319
        • Benjamin J
        • Cascade P
        • Rubenfire M
        • et al.
        Left lower lobe atelectasis and consolidation following cardiac surgery: the effect of topical cooling on the phrenicnerve.
        Radiology. 1982; 142: 11-14
        • Goodman L
        Postoperative chest radiograph: I. Alterations after abdominal surgery.
        AJR. 1980; 134: 533-541
        • Shevland JE
        • Hireleman MR
        • Hoang KA
        • et al.
        Labor collapse in the surgical intensive care unit.
        Br J Radiol. 1983; 56: 531-534
        • Pham DH
        • Huang D
        • Korwan A
        • et al.
        Acute unilateral pulmonary non-ventilation due to mucous plugs.
        Radiology. 1987; 165: 135-137
        • Bartlett JG
        • Gorbach SC
        The triple threat of aspiration pneumonia.
        Chest. 1975; 68: 560-566
        • Andrews CP
        • Coalson JJ
        • Smith JD
        • et al.
        Diagnosis of nosocomial bacterial pneumonia in acute lung disease.
        Chest. 1981; 80: 254-258
        • Roberts J
        • Barnes W
        • Pennoeh MHS
        • et al.
        Diagnostic accuracy of fever as a measure of post-operative pulmonary complications.
        heart lung. 1982; 17: 139-144
        • Goodman LR
        • Putman CE
        Intensive Care Radiology.
        CV Mosby, St. Louis1983
        • Halperin BD
        • Feeley TW
        • Mihon FG
        • et al.
        Evaluation of the portable chest roentgenogram for quantifying extravascular lung water in critically ill adults.
        Chest. 1985; 88: 649-652
        • Liebman PR
        • Philips E
        • Weisel JA
        • Ali J
        • Hectmann HB
        Limitations of portable roentgenography of the chest in patients with acute respiratory failure.
        Surg Gynecol Obstet. 1978; 146: 705-708
        • Goodman LR
        • Putman CE
        Critical Care Imaging.
        3rd ed. WB Saunders, Philadelphia1992
        • Pasternack G
        • O'Cain C
        Thoracic complications of respiratory intensive care.
        in: Herman P Iatrogenic Thoracic Complications. Springer, New York1983: 59-77
        • Winer-Muram HT
        • Rubin SA
        • Ellis JV
        • et al.
        Pneumonia and ARDS in patients receiving mechanical ventilation: diagnostic accuracy of chest radiography.
        Radiology. 1993; 188: 479-485
        • Gefter W
        • Hatabu H
        • Holland G
        • et al.
        State-of-the-art. Pulmonary thromboembolism: recent developments in diagnosis using computed tomography and magnetic resonance imaging.
        Radiology. 1995; 197: 562-574
        • Remy-Jardin M
        • Remy J
        • Wattinne L
        • Giraud F
        Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold techniquecomparison with pulmonary angiography.
        Radiology. 1992; 185: 381-387
        • Kaminsky M
        • Rodan B
        • Osborne D
        • et al.
        Postpericardiotomy syndrome.
        AJR. 1982; 138: 503-508
        • Katzberg R
        • Whitehouse G
        • de Weese J
        The early radiologic findings in the adult chest after cardiopulmonary bypass.
        Cardiovasc Radiol. 1978; 1: 205-215
        • Westcott J
        • Cole S
        Barotrauma.
        in: Herman P Iatrogenic Thoracic Complications. Springer, New York1983: 109-179
        • Steier M
        • Ching N
        • Roberts E
        • Nealon T
        Pneumothorax complicating continuous ventilatory support.
        J Thorac Cardiovasc Surg. 1974; 67: 17-23
        • Greene R
        • McLoud TC
        • Stark P
        Pneumothorax.
        Semin Roentgenol. 1977; 12: 313-325
        • Engdahl O
        • Toft T
        • Boe T
        Chest radiograph—a poor method for determining the size of a pneumothorax.
        Chest. 1993; 103: 26-29
        • Carr JJ
        • Reed JC
        • Choplin RH
        • Pope TL
        • Case ID
        Plain and computed radiography for detecting experimentally induced pneumothorax in cadavers: implications for detection in patients.
        Radiology. 1992; 183: 193-199
        • Kollef MH
        Risk factors for the misdiagnosis of pneumothorax in the intensive care unit.
        Crit Care Med. 1991; 19: 906-910
        • Heitzman ER
        The diaphragm. Radiologic correlations with anatomy and pathology.
        in: Kerley Pergamon lecture. 3rd ed. Clin Radiol. 42. 1990: 15-19
        • Horst HM
        • Fagan B
        • Beute G
        • et al.
        Chest radiographs in surgical intensive care patients: a valuable “routine.”.
        Henry Ford Hosp Med J. 1986; 34: 84-86
        • Brunel W
        • Coleman D
        • Schwartz D
        • et al.
        Assessment of routine chest roentgenograms and the physical examination to confirm endotracheal tube position.
        Chest. 1989; 96: 1043
        • Gray P
        • Sullivan G
        • Ostryzniuk P
        • et al.
        Value of postprocedural chest radiographs in the adult intensive care unit.
        Crit Car Med. 1992; 20: 1513-1518
        • Hadaway LC
        An overview of vascular access devices inserted via the antecubital area.
        J Intravenous Nursing. 1990; 13: 297-306
        • James L
        • Bledsoe L
        • Hadaway L
        A retrospective look at tip location and complications of peripherally inserted central catheter lines.
        J Intravenous Nursing. 1993; 16: 104-109
        • Munter DW
        • DeLacey WA
        Automatic implantable cardioverter-defibrillators.
        Emerg Med Clin North Am. 1994; 12: 579-595
        • Hyson E
        • Ravin C
        • Kelley M
        • Curtis A
        Intraaortic counterpulsation balloon: radiographic considerations.
        AJR. 1977; 128: 915-918
        • Daly BD
        • Cascade PN
        • Hummel JD
        • et al.
        Transvenous and subcutaneous implantable cardioverter defibrillators: radiographic assessment.
        Radiology. 1994; 191: 273-278
        • Stark P
        Manifestations of esophageal disease on plain chest radiographs.
        Postgrad Radiol. 1992; 12: 28-60
        • Teplick SK
        • Brandon JC
        • Shah HR
        • et al.
        Acute gastrointestinal disorders.
        in: Goodman LR Putnam CE Critical Care Imaging. 3rd ed. WB Saunders, Philadelphia1992: 314-318
        • Wand A
        • Davis S
        • Yankelevitz D
        • et al.
        Esophageal perforation caused by Sengstaken-Blakemore tube.
        Complications Surg. 1995; 14: 79-80

      Article info

      Publication history

      Accepted: September 1, 1995
      Received: July 27, 1995

      Identification

      DOI: https://doi.org/10.1016/0899-7071(95)00097-6

      Copyright

      © 1997 Published by Elsevier Inc.

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