Tài liệu Báo cáo y học: "Utility of routine chest radiographs in a medical–surgical intensive care unit: a qu

It is not clear whether the performance of routine CXRs alters management in patients admitted to the ICU. Studies evaluating the use of routine CXRs have mainly been in the form of prospective observational studies, with contradictory results. Fong et al found that 48% of CXRs performed in a surgical ICU were routine studies, and only 17% had an impact on clinical management [1]. In a pediatric ICU, Price et al found that 37% of CXRs could be avoided by establishing specific indications, thereby resulting in significant cost savings [2]. In a prospective study, Hall et al compared bedside clinical diagnosis with the diagnosis made from the routine CXR [3]. Of 538 routine CXRs, 8% presented new ‘major’ findings; however, 58% of these were anticipated by the clinical examination, and only 3.4% of all routine CXRs presented findings not clinically anticipated. Conversely, several studies have concluded that routine CXRs are beneficial to patient care. Brainsky et al observed that 20% of routine CXRs performed in a medical ICU had ‘major important’ findings, and 8% prompted a change in management [4].