RADIOLOGICAL THORAX MONITORING IN MECHANI CALLY VENTILATED INTENSIVE-CARE PATIENTS

Purpose: At many institutions chest x-rays (CXR) are routinely perform ed on mechanically ventilated patients on a daily basis. Among the aim s of this study was the assessment of a) frequency of clinically relev ant findings from routine CXR in surgical patients under mechanical ve ntilation, b) comparison of expectations of clinically important CXR f indings with estimation of clinical relevance of findings once films w ere obtained, c) indications and clinical consequences of findings fro m CXR requested in addition to routine films. Methods: Prospective stu dy, 40 patients with 741 CXR. Standardised film reporting. Daily recor ding of clinical data by means of an evaluation score. Interview of in tensive-care physicians for assessment of: what information was expec ted from any routine CXR? did CXR offer helpful information for furthe r treatment planning? Results: 26 % of routine CXR had a considerable therapeutical impact. 43 % of all routine CXR were expected to have an influence on patient management, 57 % were not. 16 % of those CXR tha t had been expected not to offer essential information, disclosed rele vant findings. Of the additionally obtained CXR, 53 % were performed t o check position of endotracheal tube and catheters and 47 % related t o other indications. Conclusion: Critically ill surgical patients unde r mechanical ventilation should have daily CXR follow-up, as one - fou rth of these films has an impact on the patient's management.