Could the use of bedside lung ultrasound reduce the number of chest x-rays in the intensive care unit?

Etrusca Brogi, Elena Bignami, Anna Sidoti, Mohammed Shawar, Luna Gargani, Luigi Vetrugno, Giovanni Volpicelli, Francesco Forfori, Etrusca Brogi, Elena Bignami, Anna Sidoti, Mohammed Shawar, Luna Gargani, Luigi Vetrugno, Giovanni Volpicelli, Francesco Forfori

Abstract

Background: Lung ultrasound can be used as an alternative to chest radiography (CXR) for the diagnosis and follow-up of various lung diseases in the intensive care unit (ICU). Our aim was to evaluate the influence that introducing a routine daily use of lung ultrasound in critically ill patients may have on the number of CXRs and as a consequence, on medical costs and radiation exposure.

Methods: Data were collected by conducting a retrospective evaluation of the medical records of adult patients who needed thoracic imaging and were admitted to our academic polyvalent ICU. We compared the number of CXRs and relative costs before and after the introduction of lung ultrasound in our ICU.

Results: A total of 4134 medical records were collected from January 2010 to December 2014. We divided our population into two groups, before (Group A, 1869 patients) and after (Group B, 2265 patients) the introduction of a routine use of LUS in July 2012. Group A performed a higher number of CXRs compared to Group B (1810 vs 961, P = 0.012), at an average of 0.97 vs 0.42 exams per patient. The estimated reduction of costs between Groups A and B obtained after the introduction of LUS, was 57%. No statistically significant difference between the outcome parameters of the two groups was observed.

Conclusions: Lung ultrasound was effective in reducing the number of CXRs and relative medical costs and radiation exposure in ICU, without affecting patient outcome.

Keywords: Acute care; Imaging, Ultrasound; Imaging, X-Rays; Ultrasound; X-Rays.

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained by the Research Ethics Committee of Pisa (approval number 979, 07/04/2016). Written informed consent was obtained from all the patients.

Consent for publication

Not applicable.

Competing interests

Etrusca Brogi has no conflict of interest to declare. Elena Bignami has no conflict of interest to declare. Anna Sidoti has no conflict of interest to declare. Mohammed Shawar has no conflict of interest to declare. Luna Gargani received a speaker’s honorarium from GE Healthcare. Luigi Vetrugno has no conflict of interest to declare. Giovanni Volpicelli has no conflict of interest to declare. Francesco Forfori has no conflict of interest to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Clustered cylinder chart illustrates the differences in number (a, left chart) and cost (b, right chart) of chest X-rays between Group A and Group B. The Y-axis represents total number of chest X-rays (A, left chart) or the total cost in Euros (B, right chart)

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