Type:
Educational Exhibit
Keywords:
Education, CT, Conventional radiography, Thorax, Education and training
Authors:
M. J. GAYÁN BELMONTE1, C. Botía González1, A. Sánchez González1, R. Rodríguez Mondéjar1, M. L. Rodriguez Rodriguez1, E. Cruces Fuentes2, A. P. Solano Romero1, I. CASES SUSARTE1, A. García Chiclano1; 1Murcia/ES, 2Murcia, MU/ES
DOI:
10.1594/ecr2018/C-0369
Background
Chest X-ray is a very useful tool in the critical patient.
However,
it is important to know about its indications,
as an overuse of this technique not only does not bring any additional information,
but also means more radiation for the patient.
The American College of Radiology (ACR) established,
in its ACR Appropriateness Criteria (revised in 2014),
that routine daily chest radiographs in the ICU are not indicated and the correct indications include a change in the clinical state of the patient and the placement of endotracheal or nasogastric tubes,
Swan-Ganz catheters or any other life support item [1].
In the same line,
the Spanish Society of Medical Radiology (SERAM) specifies,
in its “Not to do” Recommendations,
that chest X-rays should only be performed when a change in clinical evolution is suspected and after the placement of any life support device.
In addition,
this guide provides some interesting data,
such as the percentage of unexpected findings in daily chest x-rays is extremely low,
and only in 2.2% of cases means a change in the management.
Besides,
several studies have shown that the use of chest X-ray on demand does not alter the evolution of the patients,
but decreases the economic cost and the cost in radiation [2].