1. Routine chest roentgenography on admission to intensive care unit after heart operations: Is it of any value?
- Author
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O'Brien, Walter, Karski, Jacek M., Cheng, Davy, Carroll-Munro, Jo, Peniston, Charles, and Sandler, Alan
- Subjects
Medical equipment ,Physiological apparatus ,Radiography ,Physician and patient ,Cardiac patients ,Health - Abstract
Byline: Walter O'Brien, Jacek M. Karski, Davy Cheng, Jo Carroll-Munro, Charles Peniston, Alan Sandler Abstract: The need for routine immediate postoperative chest roentgenography after heart operations has recently been questioned. In this study we investigated the impact of routine postoperative chest roentgenography on treatment instituted in the cardiovascular intensive care unit immediately after heart operations done via median sternotomy. A total of 404 random patients admitted to the cardiovascular intensive care unit underwent clinical (positioning of endotracheal tube, nasogastric tube, and pulmonary artery catheter) and laboratory (oxygenation) assessment by a cardiovascular intensive care unit physician according to a strict protocol. After clinical assessment, chest roentgenography was done for all admitted patients and the findings reviewed by the same physician. Pathologic conditions noted were recorded on the study form together with any required treatment. Eighteen patients (4.5%) out of 404 required intervention because of abnormalities detected by the chest x-ray film but not predicted by the initial physical and laboratory assessment. None of the pathologic conditions detected was life threatening. We conclude that chest roentgenography done on admission to the cardiovascular intensive care unit should be done only if clinical and laboratory assessment indicate the possibility of underlying pathologic conditions that can only be confirmed or diagnosed by chest roentgenography. (J Thorac Cardiovasc Surg 1997;113:130-3) Article History: Received 15 April 1996; Revised 11 June 1996; Revised 11 July 1996; Accepted 19 July 1996 Article Note: (footnote) [star] From the Department of Anesthesiaa and the Division of Cardiovascular Surgeryb of The Toronto Hospital, University of Toronto, Toronto, Ontario, Canada., [star][star] Address for reprints: Jacek M. Karski, MD, Department of Anesthesia, The Toronto Hospital, 200 Elizabeth St., Toronto, Ontario, Canada, M5G 2C4., a 0022-5223/97 $5.00 + 0 12/1/76830
- Published
- 1997