Chest
Clinical Investigations in Critical CareFindings on the Portable Chest Radiograph Correlate with Fluid Balance in Critically Ill Patients
Section snippets
Materials and Methods
This investigation was approved by the institutional review boards of Vanderbilt University Medical Center and Nashville Veterans Affairs Medical Center, and informed consent was obtained for each patient.
Results
Thirty-seven patients were enrolled and completed the study protocol. CXRs from 1 treated patient were unavailable, yielding 36 patients for subsequent analysis (treatment, n = 18; control, n = 18). Eleven subsequent daily CXRs were unavailable (treatment, n = 6; control, n = 5), resulting in interpretation of 133 supine, portable, anteroposterior CXRs. There were no significant differences in any measured variable comparing the analog and digital radiographic formats. Randomization groups were
Discussion
Fluid balance is one of the most frequently manipulated clinical care variables in the ICU. The risks associated with invasive monitoring and its relationship to heightened mortality make the evaluation and utilization of other modalities for tracking volume status in critically ill patients vitally important. In this blinded systematic evaluation of portable CXRs in the ICU, we have shown that changes in fluid balance are reflected radiographically in critically ill patients. More importantly,
Chest Radiograph Data Collection Form Fluid Balance in Crirically Ill Patients*
ACKNOWLEDGMENT
The authors thank Linda Collins, RN, Susan Bozeman, RN, and our ICU patients and families. We also thank Drew Imhulse at Emory University for technical and artistic assistance.
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Supported by grants HL 07123 (Dr. Martin), HL 67739 (Dr. Martin), and AG 01023 (Dr. Ely) from the National Institutes of Health, and the AFAR Pharmacology in Aging Grant, Paul Beeson Faculty Scholar Award, and Geriatric Research and Education scholar award (Dr. Ely).