Utility of routine chest radiographs in a medical-surgical intensive care unit: a quality assurance survey

Crit Care. 2001 Oct;5(5):271-5. doi: 10.1186/cc1045. Epub 2001 Sep 6.


Objective: To determine the utility of routine chest radiographs (CXRs) in clinical decision-making in the intensive care unit (ICU).

Design: A prospective evaluation of CXRs performed in the ICU for a period of 6 months. A questionnaire was completed for each CXR performed, addressing the indication for the radiograph, whether it changed the patient's management, and how it did so.

Setting: A 14-bed medical-surgical ICU in a university-affiliated, tertiary care hospital.

Patients: A total of 645 CXRs were analyzed in 97 medical patients and 205 CXRs were analyzed in 101 surgical patients.

Results: Of the 645 CXRs performed in the medical patients, 127 (19.7%) led to one or more management changes. In the 66 surgical patients with an ICU stay <48 hours, 15.4% of routine CXRs changed management. In 35 surgical patients with an ICU stay > or = 48 hours, 26% of the 100 routine films changed management. In both the medical and surgical patients, the majority of changes were related to an adjustment of a medical device.

Conclusions: Routine CXRs have some value in guiding management decisions in the ICU. Daily CXRs may not, however, be necessary for all patients.

MeSH terms

  • Critical Care
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Prospective Studies
  • Quality Assurance, Health Care*
  • Radiography, Thoracic / statistics & numerical data*