The Interpretation of the Portable Chest Film in Intensive Care

Abstract

Although their quality is less than optimal, the antero-posterior (A-P) chest film made with portable X-ray equipment is one of the most useful tools in critical care medicine. It is a mandatory supplement to the examination of the respiratory system and should be performed daily as a routine on most seriously ill patients. During examination of the daily chest film, progress of the underlying disease is observed and compared, early changes of barotrauma looked for and the position of lines and endotracheal tubes checked. A chest film should also be performed after intrathoracic line placement or intubation, as well as in response to sudden changes in the patient’s clinical state, such as fever, hypoxia or increased ventilatory pressures. Many unsuspected abnormalities not detected on clinical examination, are seen on chest films and these often lead to major management changes [1].