title: Evaluation of medical devices in thoracic radiograms in intensive care unit - time to pay attention!
abstract: OBJECTIVE
  To identify and evaluate the correct positioning of the most commonly used medical devices as visualized in thoracic radiograms of patients in the intensive care unit of our center.
  
  
  METHODS
  A literature search was conducted for the criteria used to evaluate the correct positioning of medical devices on thoracic radiograms. All the thoracic radiograms performed in the intensive care unit of our center over an 18-month period were analyzed. All admissions in which at least one thoracic radiogram was performed in the intensive care unit and in which at least one medical device was identifiable in the thoracic radiogram were included. One radiogram per admission was selected for analysis. The radiograms were evaluated by an independent observer.
  
  
  RESULTS
  Out of the 2,312 thoracic radiograms analyzed, 568 were included in this study. Several medical devices were identified, including monitoring leads, endotracheal and tracheostomy tubes, central venous catheters, pacemakers and prosthetic cardiac valves. Of the central venous catheters that were identified, 33.6% of the subclavian and 23.8% of the jugular were malpositioned. Of the endotracheal tubes, 19.9% were malpositioned, while all the tracheostomy tubes were correctly positioned.
  
  
  CONCLUSIONS
  Malpositioning of central venous catheters and endotracheal tubes is frequently identified in radiograms of patients in an intensive care unit. This is relevant because malpositioned devices may be related to adverse events. In future studies, an association between malpositioning and adverse events should be investigated.
authors.affiliation: Departamento de Radiologia, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Ana Sofia Linhares
authors.initials: AS
authors.lastname: Moreira
authors.affiliation: Departamento de Radiologia, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Maria da Graça Alves
authors.initials: MD
authors.lastname: Afonso
authors.affiliation: Departamento de Radiologia, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Mónica Ribeiro Dos Santos Alves
authors.initials: MR
authors.lastname: Dinis
authors.affiliation: Departamento de Emergências e Terapia Intensiva, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Maria Cristina Granja Teixeira Dos
authors.initials: MC
authors.lastname: Santos
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D004864:Equipment and Supplies / Q000009:adverse effects; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D013902:Radiography, Thoracic / Q000379:methods*; D012189:Retrospective Studies