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Routine daily chest radiographs in mechanically ventilated children: necessary surveillance

Trupti V Ingle1, Shah Ali Ahmed1, John S Giuliano2

  • 1Department of Pediatrics, Section Pediatric Critical Care Medicine, Yale-New Haven Children's Hospital.

Current Opinion in Pediatrics
|April 1, 2026
PubMed

Insights

Daily chest X-rays in the pediatric intensive care unit (PICU) remain essential for detecting malpositioned devices and unexpected cardiopulmonary issues. This review supports their continued use, emphasizing their value in patient management.

Area of Science:

  • Pediatric critical care medicine
  • Diagnostic imaging
  • Radiology

Background:

  • Point-of-care technologies are increasing in pediatric intensive care units (PICUs).
  • Evidence is emerging that questions the routine use of daily chest radiographs in PICU patients.
  • This review examines the ongoing utility of daily chest imaging in this population.

Purpose of the Study:

  • To evaluate the necessity of routine daily chest radiographs in pediatric intensive care unit (PICU) patients.
  • To determine if daily chest imaging provides clinically meaningful information.
  • To assess the role of daily chest radiographs in identifying complications and guiding management.

Main Methods:

  • Literature review of studies on daily chest radiographs in PICU patients.
  • Analysis of findings related to device placement and cardiopulmonary abnormalities.
  • Consideration of radiation exposure risks and mitigation strategies.

Main Results:

  • Routine daily chest radiographs in the PICU frequently identify malpositioned devices (e.g., central venous catheters, endotracheal tubes).
  • These radiographs can uncover unanticipated cardiopulmonary abnormalities, leading to changes in patient management.
  • Potential risks of radiation exposure can be minimized with portable imaging and targeted techniques.

Conclusions:

  • Routine daily chest radiographs are a valuable tool for pediatric intensivists.
  • They have the potential to identify unexpected complications influencing patient care.
  • Future research should focus on risk stratification to identify which pediatric patients benefit most from routine radiography.
Abstract

Keywords:
chest radiographydevice malpositionpediatric intensive careresource utilization

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