[Clinical relevance of thoracic CT in intensive care and emergency medicine].
OBJECTIVE
Evaluation of the impact, indications, and therapeutic efficiency of chest CT in intensive-care and emergency patients.


METHODS
Retrospective assessment of 741 consecutive chest CT, or which 74% were acquired in the spiral technique, in intensive-care and emergency patients. Chest CT scans and respective clinical data were compared.


RESULTS
16% of all examinations were indicated to resolve questions arising from the chest radiogram, 10% to confirm or exclude pulmonary embolisms and 10% to confirm or exclude aortic dissection. In 10% a focus of infection was sought. 57% of all CT examinations had an impact on therapy, in 7% further diagnostic tests were prompted. Among a total of 588 clinical decisions based upon chest CT, the most frequent therapeutic conclusions consisted in: minimally invasive CT guided interventions in 17%. A new drug was administered in 13%, surgical intervention was performed in 13%, bed-side interventions such as insertion of a drainage tube in 13%, and a given pharmacological therapy was continued in 11%.


CONCLUSIONS
Chest CT has a strong impact on patient management in emergency and critical-care medicine. CT guided interventions are frequently used in critically-ill patients. The introduction of the spiral technique has led to important new CT indications in the field of non-invasive vascular diagnosis, namely the assessment of pulmonary embolism and aortic dissection.
Gartenschläger
M
M
Klinikum der Johannes Gutenberg-Universität Mainz.
Schweden
F
F
Düber
C
C
Weilemann
L S
LS
Ott
S
S
Westermeier
T
T
Thelen
M
M
D003422:Critical Care; D004635:Emergency Medicine; D006801:Humans; D015900:Radiography, Dual-Energy Scanned Projection; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed