Affiliations: Pediatric Intensive Care Unit, Riyadh Military Hospital, Riyadh, KSA | Pediatric Intensive Care Unit, King Abdullah Medical Center, Madinah, KSA | Pediatric Heamatology, Taibah Medical College, Madinah, KSA | Pediatric Pulmonology, Riyadh Military Hospital, Riyadh, KSA | Family and Community Medicine Department, Taibah Medical College, Madinah, KSA | Department of Public Health and Community Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Note:  Corresponding author: Khaled Kasim, Ph.D., Department of Family and Community Medicine, Faculty of Medicine, Taibah University, Madinah, Kingdom of Saudi Arabia. Tel.: +966 91966487; Fax: +966 4777714/#24603; E-mail: [email protected]
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