Chest X-ray after Tracheostomy Is Not Necessary Unless Clinically Indicated.
Summary of "Chest X-ray after Tracheostomy Is Not Necessary Unless Clinically Indicated."
BACKGROUND:
Chest radiography is routinely used post-tracheostomy to evaluate for complications. Often, the chest X-ray findings do not change clinical management. The present study was conducted to evaluate the utility of post-tracheostomy X-rays.
METHOD:
This retrospective review of 255 patients was performed at a single-center, university, level I trauma center. All patients underwent tracheostomy and were evaluated for postprocedure complications.
RESULTS:
Of the 255 patients, 95.7% had no change in postprocedure chest X-ray findings. New significant chest X-ray findings were found in 4.3% of patients, including subcutaneous emphysema, pneumothorax, and new significant consolidation. Only three of these patients required change in clinical management, and all changes were based on clinical presentation alone.
CONCLUSIONS:
Routine chest X-ray following tracheostomy fails to provide additional information beyond clinical examination. Therefore radiographic examination should be performed only after technically difficult procedures or if the patient experiences clinical deterioration. Significant cost savings and minimization of radiation exposure can be achieved when chest radiography after tracheostomy is performed exclusively for clinical indications.
Affiliation
Department of Surgery, Boston University School of Medicine, c/o Lana Ketlere, 88 East Newton Street, C515, Boston, MA, 02118, USA, William.Tobler@bmc.org.
Journal Details
This article was published in the following journal.
Name: World journal of surgery
ISSN: 1432-2323
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22167261
- DOI: http://dx.doi.org/10.1007/s00268-011-1380-4
Medical and Biotech [MESH] Definitions
Ventilators, Negative-pressure
Body ventilators that assist ventilation by applying intermittent subatmospheric pressure around the thorax, abdomen, or airway and periodically expand the chest wall and inflate the lungs. They are relatively simple to operate and do not require tracheostomy. These devices include the tank ventilators ("iron lung"), Portalung, Pneumowrap, and chest cuirass ("tortoise shell").
Acute Chest Syndrome
Respiratory syndrome characterized by the appearance of a new pulmonary infiltrate on chest x-ray, accompanied by symptoms of fever, cough, chest pain, tachypnea, or DYSPNEA, often seen in patients with SICKLE CELL ANEMIA. Multiple factors (e.g., infection, and pulmonary FAT EMBOLISM) may contribute to the development of the syndrome.
Chest Pain
Pressure, burning, or numbness in the chest.
Knee-chest Position
The posture of an individual supported by the knees and chest resting on a table.
Mass Chest X-ray
X-ray screening of large groups of persons for diseases of the lung and heart by means of radiography of the chest.
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