The utility of chest radiography following percutaneous dilational tracheotomy.
OBJECTIVE
To determine the need for routine chest radiography following percutaneous dilational tracheotomy (PDT).


METHODS
Retrospective chart review.


METHODS
Tertiary care academic medical center.


METHODS
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.


METHODS
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.
Swanson
Gregory J
GJ
Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Mich., USA.
Meleca
Robert J
RJ
Bander
Joseph
J
Stachler
Robert J
RJ
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology; D011184:Postoperative Period; D013902:Radiography, Thoracic / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014140:Tracheotomy / Q000009:adverse effects* / Q000379:methods*; D019564:Unnecessary Procedures