Abstract
Our objective was to determine the clinical value of obtaining a chest radiograph
after removal of a chest tube. We conducted a retrospective chart review of pediatric
general surgical patients with a chest tube in place after a thoracic procedure over
a 3-year time period. Postremoval films were considered to be of value if they led
to a change in clinical management. Of 468 patients who had a thoracic procedure,
281 patients had a chest tube and a postremoval film. In 263 patients (93.6%) there
was no change in the postremoval film result compared with baseline. Only two patients
(0.7%) required an intervention based on symptoms, not based on the postremoval film.
Eliminating routine postremoval radiographs after chest tube removal in pediatric
patients will lessen radiation exposure and provide cost savings with no adverse impact
on outcome.
Key Words
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References
- Thin chest wall is an independent risk factor for the development of pneumothorax after chest tube removal.The American Surgeon. 2012; 78: 478-480
Centers for Disease Control and Prevention, National Center for Health Statistics (1979). International Classifications of Diseases, Ninth Revision (ICD-9). Retrieved from https://www.cdc.gov/nchs/icd/icd9.htm.
- Is routine chest radiograph necessary after chest tube removal?.Journal of Pediatric Surgery. 2014; 49: 1493-1495
- The case for the use of evidence-based management research for the control of hospital costs.Health Care Management Review. 2003; 28: 348-365
- Optimizing postoperative care protocols in thoracic surgery: Best evidence and new technology.Journal of Thoracic Disease. 2016; 8: S3-S11
- Omission of routine chest x-ray after chest tube removal is safe in selected trauma patients.American Journal of Surgery. 2010; 199: 199-203
- The use of routine chest x-ray films after chest tube removal in postoperative cardiac patients.Annals of Thoracic Surgery. 2002; 74: 2161-2164
- Are chest radiographs routinely necessary following thoracostomy tube removal?.Pediatric Radiology. 2002; 32: 138-142
- The efficacy of x-rays after chest tube removal.American Journal of Surgery. 2000; 179: 13-16
- Is routine chest radiography indicated following chest drain removal after cardiothoracic surgery?.Interactive Cardiovascular and Thoracic Surgery. 2012; 14: 834-838
- Pneumothorax post paediatric chest drain removal.Thoracic and Cardiovascular Surgeon. 2011; 59: 302-304
- Chest radiographs after removal of chest drains in neonates: clinical benefit or common practice?.Archives of Disease in Childhood–Fetal and Neonatal Edition. 2007; 92: F46-F48
- The necessity of routine post thoracostomy tube chest radiographs in post-operative thoracic surgery patients.Surgeon. 2009; 7: 79-81
Biography
Ellen McGrath, Pediatric Nurse Practitioner, Department of General Surgery, Boston Children's Hospital, Boston, MA.
Biography
Lee Ranstrom, Pediatric Nurse Practitioner, Department of General Surgery, Boston Children's Hospital, Boston, MA.
Biography
Debra Lajoie, Director of Nursing Research Surgical Programs, Boston Children's Hospital, Boston, MA.
Biography
Lauren McGlynn, Pediatric Nurse Practitioner, Department of General Surgery, Boston Children's Hospital, Boston, MA.
Biography
David Mooney, Associate Professor of Surgery, Harvard Medical School, and Staff Surgeon, Department of General Surgery, Boston Children's Hospital, Boston, MA.
Article info
Publication history
Published online: June 14, 2017
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2017 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
