Abstract
The utility of daily routine chest X-rays (CXRs) in mechanically ventilated patients
in intensive care units is still controversial. The present study compared the diagnostic,
therapeutic and outcome efficacy between daily routine and non-routine (clinically
indicated) CXRs in children patients in pediatric intensive care unit (PICU). A prospective
randomized study conducted in tertiary center 18-bed PICU, Riyadh Military Hospital,
Riyadh, Kingdom of Saudi Arabia. The study selected 52 children, who were mechanically
intubated for at least 48 hr. The children were randomized to receive either routine
(29 patients) or non-routine (23 patients) CXRs and were followed until extubation
or death. Demographic and outcome data were collected and analyzed as appropriate.
Although children in the non-routine group received fewer CXRs, the lengths of stay
(LOS) in intensive care unit and hospital and mortality rate were nearly the same
compared with routine group. The percentage of CXRs with new findings was higher in
the non-routine group (83%; 53 CXRs) compared to that in the routine group (69%; 156
CXRs) with an odds ratio (OR) of 2.10 (95% confidence interval [CI] = 0.60–8.11).
Also, the percentage of CXRs with new findings that result in intervention was higher
in non-routine group (78% vs. 69%; OR = 1.60; 95% CI = 0.50–5.70). The daily routine
CXRs was not associated with a reduced effect on length of stay in PICU and hospital
or mortality and it does not seem to add any advantages over non-routine CXRs in PICU.
Large multicenter studies are needed to confirm these results.
Keywords
Daily routine - chest X-ray - children - intensive care unit - mechanical ventilation
