Chest radiography in intensive care units

The role chest radiography plays in intensive care units (ICU) is unlike its role elsewhere because in the ICU a patient's underlying disease is usually known. Furthermore, additional diseases that develop in the ICU-such as pneumonia, hemorrhage, edema, lung collapse and effusion-often are radiographically indistinguishable. Nevertheless, an ICU radiograph of the chest is valuable, mainly in identifying such complications as malpositioned intravenous catheters, Swan-Ganz catheters, pacemakers, nasogastric tubes, endotracheal tubes, chest tubes, and mediastinal tubes, and ectopic gas related to mechanical ventilation. Understanding the limitations of the portable ICU chest film in the diagnosis of specific diseases and being alert to possible iatrogenic complications will increase the usefulness of ICU chest radiography.