Open AccessChest X‐ray after Tracheostomy Is Not Necessary Unless Clinically Indicated
Author(s) -
Tobler William D.,
Mella Juan R.,
Ng Joanna,
Selvam Anand,
Burke Peter A.,
Agarwal Suresh
Publication year - 2012
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-011-1380-4
Subject(s) - medicine , pneumothorax , radiography , subcutaneous emphysema , single center , radiology , cardiothoracic surgery , surgery
Background Chest radiography is routinely used post‐tracheostomy to evaluate for complications. Often, the chest X‐ray findings do not change clinical management. The present study was conducted to evaluate the utility of post‐tracheostomy X‐rays. Method This retrospective review of 255 patients was performed at a single‐center, university, level I trauma center. All patients underwent tracheostomy and were evaluated for postprocedure complications. Results Of the 255 patients, 95.7% had no change in postprocedure chest X‐ray findings. New significant chest X‐ray findings were found in 4.3% of patients, including subcutaneous emphysema, pneumothorax, and new significant consolidation. Only three of these patients required change in clinical management, and all changes were based on clinical presentation alone. Conclusions Routine chest X‐ray following tracheostomy fails to provide additional information beyond clinical examination. Therefore radiographic examination should be performed only after technically difficult procedures or if the patient experiences clinical deterioration. Significant cost savings and minimization of radiation exposure can be achieved when chest radiography after tracheostomy is performed exclusively for clinical indications.