Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation
Keywords:
Chest x-ray findings, PICU, mechanical ventilation
Abstract
Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonary
disease as underlying conditions. Mechanical ventilation may be
used to limit morbidity and mortality in children with respiratory
failure.
Objective To assess a correlation between chest x-ray findings
and outcomes of patients with mechanical ventilation.
Methods This retrospective study was held in Dr. Kariadi
Hospital, Semarang, Indonesia. Data was collected from the
medical records of children admitted to the PICU from January
to December 2010, who suffered from respiratory distress and
used mechanical ventilation. We compared chest x-ray findings to
the outcomes of patients. Radiological expertise was provided by
radiologists on duty at the time. Chi-square and logistic regression
tests were used for statistical analysis.
Results There were 63 subjects in our study, consisting of 28 males
and 35 females. Patient outcomes were defined as survived or died,
43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-ray
findings revealed the following conditions: bronchopneumonia
48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%
(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%
(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;
95%CI 0.03 to 7 .62). None of the chest x-ray findings significantly
correlated to patient outcomes.
Conclusion Chest x-ray findings do not correlate to patient
outcomes in pediatric subjects with mechanical ventilation in
the PICU of Dr. Kariadi Hospital, Semarang, Indonesia.
References
1. Newth CJL, Venkataraman S, Willson DF, Meert KL,
Harrison R, Dean JM, et al. Weaning and extubation
readiness in pediatric patients. Pediatr Crit Care Med.
2009;10:1-ll.
2. Mehta NM, Arnold JH. Mechanical ventilation in children
with acute r espiratory failure. Curr Opin Crit Care.
2004;10:7- 12.
3. Kendirli T, Kavaz A, Yalaki Z, Hi§mi BO, Derelli E, ince
E. Mechanical ventilation in children. Turk J Pediatr.
2006;48:323-7.
4. Silva DC, Shibata AR, Farias JA, Troster EJ. How is
mechanical ventilation employed in pediatric intensive care unit in Brazil? Clinics. 2009;64: 1161-6.
5. Trotman-Dickenson B. Radiology in the intensive care unit
(Partl). J Intensive Care Med. 2003; 18: 198-2 10.
6. Graat ME, Choi G, Wolthuis EK, Korevaar JC, Spronk
PE, Stoker J, et al. The clinical value of daily routine chest
radiographs in a mixed medical-surgical intensive care unit
is low. Crit Care. 2006; 10: 11.
7. Chambliss CR, Petrillo T, Lecnick BL, Sullivan K. Do
pediatric intensivists and radiologists concur on the
interpretation of chest radiographs? Crit Care. 1998;2:67-
72.
8. Graat ME, Hendrikse KA, Spronk PE, Korevaar JC, Stoker
J, Schultz MJ. Chest radiography practice in critically ill
patients: a postal survey in the Netherlands. BMC Med
Imaging. 2006;6:8.
9. Aquino SL, Khan A, Batra PY, Gurney JW, Haramati LB,
MacMahon H, et al. Routine daily portable X-ray. ACR
Appropriateness Criteria. Available from: dcamedical.
com/webdocuments/ appropriateness -criteria-routine -chestxray.
pdf
10. Srinivasan R, Asselin J, Gildengorin G, Wiener-Kronish
J, Flori HR. A prospective study of ventilator-associated
pneumonia in children. Pediatrics. 2009; 123: 1108.
11. Meaney PA, Nadkami VM, Cook EF, Testa M, Helfaer M,
Kaye W, er al. Higher survival rates among younger patients
after pediatric intensive care unit cardiac arrests. Pediatrics.
2006;118:2424.
12. Embu HY, Yiltok SJ, Isamade ES, Nuhu SI, Oyeniran 00,
Uba FA. Paediatric admissions and outcomes in a general
intensive care unit. Afr J Paediatr Surg. 2011 ;8:57-6 1.
13. Edmunds S, Weiss I, Harrison R. Extubation failure in a Large
pediatric ICU population. Chest. 2001; 11 9:897-900.
14. Payen V, Jouvet P, Lacroix }, DucruetT, Gauvin F. Risk factors
associated with increased length of mechanical ventilation
in children. Pediatr Crit Care. 2012; 13: 152-7.
15. Krivopal M, Shlobin OA, Schwartzstein RM. Utility of
daily routine portable chest radiographs in mechanically
ventilated patients in the medical ICU. Chest. 2003;
123:1607-14.
16. Quasney MW, Goodman DM, Billow M, Chiu H, Easterling
L, Frankel L, et al. Routine chest radiographs in pediatric
intensive care units. Pediatrics. 200 1;107:241 -8.
17. Hendrikse KA, GratamaJWC, Hove W, RommesJH, Schultz
MJ, Spronk PE. Low value of routine chest radiographs in a
mixed medical-surgical ICU. Chest. 2007; 132:823-8.
18. Oba Y, Zaza T. Abandoning daily routine chest radiography
in the intensive care unit: meta-analysis. Radiology.
2010;255:386-95.
19. Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier
P, Rouby JJ. Comparative diagnostic performances of
auscultation, chest radiography, and lung ultrasonography
in acute respiratory distress syndrome. Anesthesiology.
2004; 100:9-15.
20. Sands R, Manning JC, Vyas H, Rashid A Characteristics of
deaths in paediatric intensive care: a 10-year study. Nurs Crit
Care. 2009;14:235-40.
21. Yates K, Festa M, Gillis J, Waters K, North K. Outcomes of
children with neuromuscular disease admitted to paediatric
intensive care. Arch Dis Child. 2004;89:170-5.
22. Costa GA, Delgado AF, Ferraro A, Okay TS. Application
of the pediatric risk of mortality (PRISM) score and
determination of mortality risk factors in a tertiary pediatric
intensive care unit. Clinics. 2010;65:1087-92.
23. Brady AR, Harrison D, Black S, Jones S, Rowan K, Pearson
G, et al. Assessment and optimization of mortality prediction
tools for admissions to pediatric intensive care in the United
Kingdom. Pediatrics. 2006; 117: 7 33.
24. Epstein SK. Weaning from ventilatory support. Curr Opin
Crit Care. 2009;15:36-43.
25. Hirshberg E, Larsen G, Van Duker H. Alterations in
glucose homeostasis in the pediatric intensive care unit:
hyperglycemia and glucose variability are associated with
increased mortality and morbidity. Pediatr Crit Care Med.
2008;9:36 l-6.
26. Wintergerst KA, Buckingham B, Gandrud L, Wong BJ, Kache
S, Wilson DM. Association of hypoglycemia, hyperglycemia,
and glucose variability with morbidity and death in the
pediatric intensive care unit. Pediatrics. 2006;118:173.
27. Leclerc F, Leteurtre S, Duhamel A, Grandbastien B, Proulx F,
Martinot A, et al. Cumulative influence of organ dysfunctions
and septic state on mortality of critically ill children. Am J
Respir Crit Care Med. 2005;171:348-53.
Harrison R, Dean JM, et al. Weaning and extubation
readiness in pediatric patients. Pediatr Crit Care Med.
2009;10:1-ll.
2. Mehta NM, Arnold JH. Mechanical ventilation in children
with acute r espiratory failure. Curr Opin Crit Care.
2004;10:7- 12.
3. Kendirli T, Kavaz A, Yalaki Z, Hi§mi BO, Derelli E, ince
E. Mechanical ventilation in children. Turk J Pediatr.
2006;48:323-7.
4. Silva DC, Shibata AR, Farias JA, Troster EJ. How is
mechanical ventilation employed in pediatric intensive care unit in Brazil? Clinics. 2009;64: 1161-6.
5. Trotman-Dickenson B. Radiology in the intensive care unit
(Partl). J Intensive Care Med. 2003; 18: 198-2 10.
6. Graat ME, Choi G, Wolthuis EK, Korevaar JC, Spronk
PE, Stoker J, et al. The clinical value of daily routine chest
radiographs in a mixed medical-surgical intensive care unit
is low. Crit Care. 2006; 10: 11.
7. Chambliss CR, Petrillo T, Lecnick BL, Sullivan K. Do
pediatric intensivists and radiologists concur on the
interpretation of chest radiographs? Crit Care. 1998;2:67-
72.
8. Graat ME, Hendrikse KA, Spronk PE, Korevaar JC, Stoker
J, Schultz MJ. Chest radiography practice in critically ill
patients: a postal survey in the Netherlands. BMC Med
Imaging. 2006;6:8.
9. Aquino SL, Khan A, Batra PY, Gurney JW, Haramati LB,
MacMahon H, et al. Routine daily portable X-ray. ACR
Appropriateness Criteria. Available from: dcamedical.
com/webdocuments/ appropriateness -criteria-routine -chestxray.
10. Srinivasan R, Asselin J, Gildengorin G, Wiener-Kronish
J, Flori HR. A prospective study of ventilator-associated
pneumonia in children. Pediatrics. 2009; 123: 1108.
11. Meaney PA, Nadkami VM, Cook EF, Testa M, Helfaer M,
Kaye W, er al. Higher survival rates among younger patients
after pediatric intensive care unit cardiac arrests. Pediatrics.
2006;118:2424.
12. Embu HY, Yiltok SJ, Isamade ES, Nuhu SI, Oyeniran 00,
Uba FA. Paediatric admissions and outcomes in a general
intensive care unit. Afr J Paediatr Surg. 2011 ;8:57-6 1.
13. Edmunds S, Weiss I, Harrison R. Extubation failure in a Large
pediatric ICU population. Chest. 2001; 11 9:897-900.
14. Payen V, Jouvet P, Lacroix }, DucruetT, Gauvin F. Risk factors
associated with increased length of mechanical ventilation
in children. Pediatr Crit Care. 2012; 13: 152-7.
15. Krivopal M, Shlobin OA, Schwartzstein RM. Utility of
daily routine portable chest radiographs in mechanically
ventilated patients in the medical ICU. Chest. 2003;
123:1607-14.
16. Quasney MW, Goodman DM, Billow M, Chiu H, Easterling
L, Frankel L, et al. Routine chest radiographs in pediatric
intensive care units. Pediatrics. 200 1;107:241 -8.
17. Hendrikse KA, GratamaJWC, Hove W, RommesJH, Schultz
MJ, Spronk PE. Low value of routine chest radiographs in a
mixed medical-surgical ICU. Chest. 2007; 132:823-8.
18. Oba Y, Zaza T. Abandoning daily routine chest radiography
in the intensive care unit: meta-analysis. Radiology.
2010;255:386-95.
19. Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier
P, Rouby JJ. Comparative diagnostic performances of
auscultation, chest radiography, and lung ultrasonography
in acute respiratory distress syndrome. Anesthesiology.
2004; 100:9-15.
20. Sands R, Manning JC, Vyas H, Rashid A Characteristics of
deaths in paediatric intensive care: a 10-year study. Nurs Crit
Care. 2009;14:235-40.
21. Yates K, Festa M, Gillis J, Waters K, North K. Outcomes of
children with neuromuscular disease admitted to paediatric
intensive care. Arch Dis Child. 2004;89:170-5.
22. Costa GA, Delgado AF, Ferraro A, Okay TS. Application
of the pediatric risk of mortality (PRISM) score and
determination of mortality risk factors in a tertiary pediatric
intensive care unit. Clinics. 2010;65:1087-92.
23. Brady AR, Harrison D, Black S, Jones S, Rowan K, Pearson
G, et al. Assessment and optimization of mortality prediction
tools for admissions to pediatric intensive care in the United
Kingdom. Pediatrics. 2006; 117: 7 33.
24. Epstein SK. Weaning from ventilatory support. Curr Opin
Crit Care. 2009;15:36-43.
25. Hirshberg E, Larsen G, Van Duker H. Alterations in
glucose homeostasis in the pediatric intensive care unit:
hyperglycemia and glucose variability are associated with
increased mortality and morbidity. Pediatr Crit Care Med.
2008;9:36 l-6.
26. Wintergerst KA, Buckingham B, Gandrud L, Wong BJ, Kache
S, Wilson DM. Association of hypoglycemia, hyperglycemia,
and glucose variability with morbidity and death in the
pediatric intensive care unit. Pediatrics. 2006;118:173.
27. Leclerc F, Leteurtre S, Duhamel A, Grandbastien B, Proulx F,
Martinot A, et al. Cumulative influence of organ dysfunctions
and septic state on mortality of critically ill children. Am J
Respir Crit Care Med. 2005;171:348-53.
Published
2013-02-28
How to Cite
1.
Nurhayati I, Supriatna M, Raharjani K, Sudijanto E. Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation. PI [Internet]. 28Feb.2013 [cited 23Nov.2024];53(1):6-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/238
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2016-08-18
Accepted 2016-08-18
Published 2013-02-28
Accepted 2016-08-18
Published 2013-02-28
