Document Detail

The value of routine chest radiographs in a paediatric intensive care unit: a prospective study.
MedLine Citation:
PMID:  11373922     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In many paediatric intensive care units (PI-CUs) chest X-ray films (CXRs) are required as part of the daily examination or after completion of invasive procedures. OBJECTIVE: First, to evaluate if the American College of Radiology (ACR) guidelines for adult patients are appropriate for paediatric patients. Second, to assess the diagnostic efficacy of the CXRs. MATERIALS AND METHODS: One-hundred-seventy-four CXRs acquired in 74 patients, either routinely or after invasive procedures, were analysed. The indication of the obtained CXRs, or the absence of indication in patients in whom no CXRs was taken, was compared with ACR guidelines. The position of medical devices was evaluated. Changes in cardiopulmonary status were noted. RESULTS: Sixty-seven percent of the CXRs were in accordance with the ACR guidelines, and in 74% of patients in whom no CXRs were taken this was also in accordance with these guidelines. Sixteen percent of the endotracheal tubes, 23% of central venous lines and 15% of nasogastric tubes were malpositioned. Changes in cardiopulmonary status, after the initial film, were noted in 63%. CONCLUSIONS: The indications for the majority of CXRs in our PICU appeared to be in accordance with ACR guidelines. The high percentage of malpositioned tubes and lines and the number of cardiopulmonary changes on CXRs in a PICU underline the value of these films. Adjustments of the ACR guidelines for particular groups of paediatric patients may limit the number of CXRs taken and may further increase diagnostic efficacy.
J W Valk; F B Plötz; F A Schuerman; H van Vught; P P Kramer; E J Beek
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Pediatric radiology     Volume:  31     ISSN:  0301-0449     ISO Abbreviation:  Pediatr Radiol     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-25     Completed Date:  2001-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  343-7     Citation Subset:  IM    
Department of Radiology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
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MeSH Terms
Child, Preschool
Equipment and Supplies
Infant, Newborn
Intensive Care / methods
Intensive Care Units, Pediatric / standards*
Practice Guidelines as Topic / standards
Prospective Studies
Radiography, Thoracic*

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