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Guidelines for Reading and Interpreting Chest Radiographs in Patients Receiving Mechanical Ventilation

Published online by Cambridge University Press:  21 June 2016

Helen T. Winer-Muram
Affiliation:
Department of Radiology, The University of Tennessee, Memphis Department of Radiology, University of Texas Medical Branch, Galveston CNR Institute of Clinical Physiology, Pisa, Italy Department of Radiology, Veterans Affairs Medical Center Memphis
Sanford A. Rubin
Affiliation:
Department of Radiology, The University of Tennessee, Memphis Department of Radiology, University of Texas Medical Branch, Galveston CNR Institute of Clinical Physiology, Pisa, Italy Department of Radiology, Veterans Affairs Medical Center Memphis
Massimo Miniati
Affiliation:
Department of Radiology, The University of Tennessee, Memphis Department of Radiology, University of Texas Medical Branch, Galveston CNR Institute of Clinical Physiology, Pisa, Italy Department of Radiology, Veterans Affairs Medical Center Memphis
James V. Ellis
Affiliation:
Department of Radiology, The University of Tennessee, Memphis Department of Radiology, University of Texas Medical Branch, Galveston CNR Institute of Clinical Physiology, Pisa, Italy Department of Radiology, Veterans Affairs Medical Center Memphis

Extract

The technical limitations of portable chest radiography, the lack of lateral radiographs, and the difficulties in positioning critically ill patients hinder the radiologic diagnosis of pneumonia, especially in patients receiving mechanicalventilation (MV). Optimally, anteroposterior (AP) portable radiographs are obtained utilizing high kilovoltage (120 to 130 kV), short exposure time, and fast filmscreen combinations to increase radiographic latitude and decrease motion unsharpness. Whenever possible, constant source-tofilm and source-to-patient distance should be maintained to allow for proper assessment of changes in mediastinal or cardiac diameters. Multiple factors should be recorded, including radiographic technique, focus-film distance, kilovoltage (kv), milliampere (mA), patient position, and ventilator settings for positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP).

Type
Proceedings of the First International Consensus Conference on the Clinical Investigation of Ventilator-Associated Pneumonia
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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