An integrated approach for prescribing fewer chest x-rays in the ICU. - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles Annals of Intensive Care Year : 2011

An integrated approach for prescribing fewer chest x-rays in the ICU.

Abstract

ABSTRACT: Chest x-rays (CXRs) are the main imaging tool in intensive care units (ICUs). CXRs also are associated with concerns inherent to their use, considering both healthcare organization and patient perspectives. In recent years, several studies have focussed on the feasibility of lowering the number of bedside CXRs performed in the ICU. Such a decrease may result from two independent and complementary processes: a raw reduction of CXRs due to the elimination of unnecessary investigations, and replacement of the CXR by an alternative technique. The goal of this review is to outline emblematic examples corresponding to these two processes. The first part of the review concerns the accumulation of evidence-based data for abandoning daily routine CXRs in mechanically ventilated patients and adopting an on-demand prescription strategy. The second part of the review addresses the use of alternative techniques to CXRs. This part begins with the presentation of ultrasonography or capnography combined with epigastric auscultation for ensuring the correct position of enteral feeding tubes. Ultrasonography is then also presented as an alternative to CXR for diagnosing and monitoring pneumothoraces, as well as a valuable post-procedural technique after central venous catheter insertion. The combination of the emblematic examples presented in this review supports an integrated global approach for decreasing the number of CXRs ordered in the ICU.
Fichier principal
Vignette du fichier
2110-5820-1-4.pdf (1.09 Mo) Télécharger le fichier
2110-5820-1-4.xml (60.67 Ko) Télécharger le fichier
Origin : Publisher files allowed on an open archive
Format : Other
Loading...

Dates and versions

inserm-00580952 , version 1 (29-03-2011)

Identifiers

Cite

Vincent Ioos, Arnaud Galbois, Ludivine Chalumeau-Lemoine, Bertrand Guidet, Eric Maury, et al.. An integrated approach for prescribing fewer chest x-rays in the ICU.. Annals of Intensive Care, 2011, 1 (1), pp.4. ⟨10.1186/2110-5820-1-4⟩. ⟨inserm-00580952⟩
143 View
176 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More