Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2007 Apr;33(4):639-44.
doi: 10.1007/s00134-007-0542-1. Epub 2007 Feb 28.

Elimination of daily routine chest radiographs in a mixed medical-surgical intensive care unit

Marleen E Graat  1 , Anke Kröner, Peter E Spronk, Johanna C Korevaar, Jaap Stoker, Margreeth B Vroom, Marcus J Schultz
Affiliations
Clinical Trial

Elimination of daily routine chest radiographs in a mixed medical-surgical intensive care unit

Marleen E Graat et al. Intensive Care Med. 2007 Apr.

Abstract

Objective: To determine the impact of elimination of daily routine chest radiographs (CXRs) in a mixed medical-surgical intensive care unit (ICU) on utility of on demand CXRs, length of stay (LOS) in ICU, readmission rate, and mortality rate.

Design and setting: Prospective, nonrandomized, controlled study in a 28-bed ICU. Analysis included data of all admitted ICU patients during 5 months before and after elimination of daily routine CXRs.

Results: Before elimination, 2457 daily routine CXRs and 1437 on demand CXRs were obtained from 754 patients. After elimination, 1267 CXRs were obtained from 622 patients. The ratio of CXRs/patient day decreased from 1.1+/-0.3 to 0.6+/-0.4 (p<0.05). Elimination did not result in a change in utility and timing of on demand CXRs. The absolute diagnostic and therapeutic value of on demand CXRs increased with elimination of daily routine CXRs: before intervention, 147 unexpected predefined abnormalities were found (10.2% of all on demand CXRs in 15.9% of all patients), of which 57 (3.9%) in 6.4% of all patients led to a change in therapy. After intervention, 156 unexpected predefined abnormalities were found (11.6%; p<0.05), of which 61 (4.8%) in 9.5% of all patients (p<0.05) led to a change in therapy. The LOS in ICU, readmission rate and ICU, and hospital mortality rate were not influenced by the change in strategy.

Conclusions: Elimination of daily routine CXRs reduced the number of CXRs in a mixed medical-surgical ICU, while not affecting readmission rate and ICU and hospital mortality rates.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Number of CXRs/day during the study. Phase 1: daily routine CXR strategy, i.e., a daily routine CXR was made every morning, from March to July; phase 2: on demand CXR strategy, i.e., each CXR required a clinical indication, from September to January. Open bars: mean number (± SD) of on demand CXRs/day; closed symbols: mean number (± SD) of all CXRs/day
See this image and copyright information in PMC

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1177/0885066603251897', 'is_inner': False, 'url': 'https://doi.org/10.1177/0885066603251897'}, {'type': 'PubMed', 'value': '15035766', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15035766/'}]}
    2. Trotman-Dickenson B (2003) Radiology in the intensive care unit (Part I). J Intensive Care Med 18:198–210 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1378/chest.128.1.296', 'is_inner': False, 'url': 'https://doi.org/10.1378/chest.128.1.296'}, {'type': 'PMC', 'value': 'PMC1557847', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC1557847/'}, {'type': 'PubMed', 'value': '16848892', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16848892/'}]}
    2. Graat ME, Spronk PE, Schultz MJ (2005) Current practice of chest radiography in critically ill patients in the Netherlands: a postal survey. Chest 128:S296 - PMC - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00003246-199105000-00015', 'is_inner': False, 'url': 'https://doi.org/10.1097/00003246-199105000-00015'}, {'type': 'PubMed', 'value': '2026031', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/2026031/'}]}
    2. Hall JB, White SR, Karrison T (1991) Efficacy of daily routine chest radiographs in intubated, mechanically ventilated patients. Crit Care Med 19:689–693 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1177/0885066605277212', 'is_inner': False, 'url': 'https://doi.org/10.1177/0885066605277212'}, {'type': 'PubMed', 'value': '16061907', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16061907/'}]}
    2. Graat ME, Stoker J, Vroom MB, Schultz MJ (2005) Can we abandon daily routine chest radiography in intensive care patients? J Intensive Care Med 20:238–246 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1186/cc3955', 'is_inner': False, 'url': 'https://doi.org/10.1186/cc3955'}, {'type': 'PMC', 'value': 'PMC1550788', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC1550788/'}, {'type': 'PubMed', 'value': '16420655', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16420655/'}]}
    2. Graat M, Wolthuis E, Choi G, Korevaar JC, Spronk PE, Stoker J, Vroom M, Schultz M (2005) The clinical value of daily-routine chest radiographs in a mixed medical-surgical intensive care units is low. Crit Care 10:1–7 - PMC - PubMed

Publication types