title: Routine chest radiograph is not indicated after open tracheostomy: a multicenter perspective.
abstract: Obtaining a chest radiograph (CXR) after open tracheostomy has been standard practice for many surgeons. We hypothesized that routine CXR after uncomplicated open tracheostomy is unnecessary. A prospective multicenter protocol was carried out on adult surgical patients undergoing uncomplicated tracheostomy. CXR was not routinely ordered in the immediate postoperative period but was obtained only for clinical indications. Preoperative and subsequent postoperative CXRs were reviewed for evidence of complications. Twenty-two surgeons at four institutions performed 151 tracheostomies. Posttracheostomy CXR was not diagnostic in four patients with potential tracheostomy-related complications (i.e., tachypnea, tachycardia, desaturation, and elevated peak airway pressure). In the 147 patients without clinical indications for CXR subsequent CXR revealed no significant new findings. In this era of cost containment the need for CXR after tracheostomy must be questioned. Routine CXR is not indicated or cost effective after uncomplicated open tracheostomy in adults.
authors.affiliation: Department of Surgery, Texas Tech University Health Sciences Center, El Paso 79905-2700, USA.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Tyroch
authors.forename: Krista
authors.initials: K
authors.lastname: Kaups
authors.forename: Manuel
authors.initials: M
authors.lastname: Lorenzo
authors.forename: Martin
authors.initials: M
authors.lastname: Schreiber
authors.forename: Diego
authors.initials: D
authors.lastname: Solis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013902:Radiography, Thoracic / Q000191:economics / Q000706:statistics & numerical data*; D014139:Tracheostomy; D014481:United States