On-demand rather than daily-routine chest radiography prescription may change neither the number nor the impact of chest computed tomography and ultrasound studies in a multidisciplinary intensive care unit.

Abstract:

BACKGROUND:Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. METHODS:This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods of 5 months, one before and one after elimination of daily-routine CXR. Chest CT and ultrasound studies were identified retrospectively by using the radiology department information system. Indications for and the diagnostic/therapeutic yield of chest CT and ultrasound studies were collected. RESULTS:Elimination of daily-routine CXR resulted in a decrease of CXRs per patient day from 1.1 +/- 0.3 to 0.6 +/- 0.4 (P < 0.05). Elimination did not affect duration of stay or mortality rates. Neither the number of chest CT studies nor the ratio of chest CT studies per patient day changed with the intervention: Before elimination of daily-routine CXR, 52 chest CT studies were obtained from 747 patients; after elimination, 54 CT studies were obtained from 743 patients. Similarly, chest ultrasound practice was not affected by the change of CXR strategy: Before and after elimination, 21 and 27 chest ultrasound studies were performed, respectively. Also, timing of chest CT and ultrasound studies was not different between the two study periods. During the two periods, 40 of 106 chest CT studies (38%) and 18 of 48 chest ultrasound studies (38%) resulted in a change in therapy. The combined therapeutic yield of chest CT and ultrasound studies did not change with elimination of daily-routine CXR. CONCLUSIONS:Elimination of daily-routine CXRs may not affect chest CT and ultrasound practice in a multidisciplinary intensive care unit.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Kröner A,Binnekade JM,Graat ME,Vroom MB,Stoker J,Spronk PE,Schultz MJ

doi

10.1097/01.anes.0000296069.00566.16

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

40-5

issue

1

eissn

0003-3022

issn

1528-1175

pii

00000542-200801000-00009

journal_volume

108

pub_type

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