Chest X-Ray in ICU setting

Thoracic Imaging in the Intensive Care Unit
Joel E. Fishman, MD, PhD; Steven L. Primack, MD

Physical examination is often difficult in the intensive care unit (ICU) setting and for many years has been complemented by the portable chest radiograph (CXR). The interpretation of portable ICU radiographs may also be difficult because of the limitations of applying optimal radiographic technique in the ICU setting, as well as the patient's condition and the presence of monitoring and other devices (either in or on the patient) that might obscure portions of the chest.

The American College of Radiology has addressed these issues in its Appropriateness Criteria, stating that a daily CXR is indicated for patients with acute cardiopulmonary problems and for patients on mechanical ventilation. In patients with a central venous catheter, a Swan-Ganz catheter, a feeding tube, or a chest tube placement, only postprocedure radiographs are indicated. Stable cardiac monitoring patients and those with purely extrathoracic disease require only admission films upon entry into the ICU.

Full article in-

Appl Radiol. 2005;34(12):8-17