THE CLINICAL-VALUE OF SCREENING CHEST RADIOGRAPHY IN THE NEONATE WITHLUNG-DISEASE

To examine the role of routine chest radiography in the management of the critically ill neonate with pulmonary disease, 41 term and preterm infants with lung diseases were prospectively evaluated. Seventy radi ographs (35%) were obtained for clinical indications and 128 (65%) for prospective screening. Studies were compared with each infant's most recent previous study, if available. Every exam was designated Level 1 , if the radiograph identified a new finding that required clinical in tervention; Level II, if an abnormality or interval change was observe d that did not require immediate intervention; or Level III, if there was no interval change since the previous radiograph. Thirty-three (47 %) indication radiographs and 63 (49%) screening radiographs showed si gnificant changes since the previous study. Twenty-four (34%) of the i ndication radiographs and 42 (33%) of the screening radiographs had Le vel I abnormalities (P = NS). Nine (13%) of the indication radiographs and 21 (16%) of the screening radiographs had Level II abnormalities (P = NS). Results suggest that routine screening chest radiographic st udies are an important adjunct of care in critically ill newborns with respiratory disease and may identify potential problems before they a re reflected in a change in clinical status.