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The Utility of Chest Radiography Following Percutaneous Dilational Tracheotomy
Gregory J. Swanson, MD,PhD;
Robert J. Meleca, MD;
Joseph Bander, MD;
Robert J. Stachler, MD
Arch Otolaryngol Head Neck Surg. 2002;128:1253-1254.
Objective To determine the need for routine chest radiography following percutaneous dilational tracheotomy (PDT).
Design Retrospective chart review.
Setting Tertiary care academic medical center.
Patients The records of 119 patients undergoing PDT between 1993 and 2000 for indications of prolonged intubation or need for pulmonary toilet. All patients received a portable chest radiograph immediately following the procedure.
Outcome Measure Incidence of postoperative pneumothorax or pneumomediastinum.
Results One patient (0.8%) undergoing PDT experienced a postoperative pnuemothorax. This patient was noted to have respiratory distress within 10 minutes following the procedure, suggesting a pneumothorax. A postoperative chest radiograph confirmed the clinical impression. No asymptomatic patients were diagnosed as having a pnuemothorax or pneumomediastinum using postoperative chest radiography.
Conclusions Chest radiography following PDT is indicated when there are clinical findings suggesting pneumothorax or pneumomediastinum. Without clinical signs or symptoms, routine use of postoperative chest radiographs are unnecessary and not cost-effective.
From the Departments of Otolaryngology–Head and Neck Surgery (Drs Swanson, Meleca, and Stachler) and Internal Medicine, Division of Critical Care Medicine (Dr Bander), Wayne State University, Detroit, Mich.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Role of routine chest radiography after percutaneous dilatational tracheostomy
Kumar et al.
Br J Anaesth 2008;100:663-666.
ABSTRACT
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