X-Rays Overused in ICU: Ultrasound Safer, Just as Effective

“We found that the use of ultrasound to diagnose patients greatly reduced radiation exposure for patients without negatively affecting their health,” said Margarita Oks, MD, Long Island Jewish Hospital, North Shore-LIJ Health System. “It was also cost-effective.”

Ultrasound, also called sonography, is an imaging method that uses high-frequency sound waves to produce images that lead to diagnosis and treatment of many diseases and medical conditions. Radiation is not used in ultrasound testing, but is used in x-rays and CT scans.

Dr. Oks and her colleagues studied medical charts covering 3 months of data comparing chest x-rays, CT scans, and ultrasound between two independent but similar medical intensive care units staffed by the same medical house staff in one health-care system. One unit used bedside ultrasound as the standard of care for diagnosis; the second used conventional imaging, such as x-rays and CT scans, as its standard of care in diagnosis.

Researchers found that there were 5.21 x-rays done per patient stay in the ICU using x-rays and CT scans, while there were 1.10 x-rays per patient stay in the unit using ultrasound as the standard of care. Total CT scans were 0.91 in the nonultrasound ICU vs 0.26 per patient stay in the ultrasound unit. There were 0.27 cardiac echocardiograms in the nonultrasound ICU vs 0.11 in the ultrasound ICU per patient stay. Mortality rates did not differ greatly, with 0.27 in the nonultrasound ICU vs 0.20 in the ultrasound ICU.

CHEST 2013 is the 79th annual meeting of the American College of Chest Physicians, held October 26-31 in Chicago, Illinois. The ACCP is the global leader in clinical chest medicine, representing 18,700 members who provide patient care in the areas of pulmonary, critical care, and sleep medicine in the United States and throughout the world. The mission of the ACCP is to promote the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. For information about the ACCP, visit the ACCP website at www.chestnet.org, or follow the ACCP on Facebook and Twitter and the meeting hashtag, #CHEST2013.

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