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Clinical Value of Computed Tomography in Patients with Acute Respiratory Failure Who Admitted to Micu
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A6811 - Clinical Value of Computed Tomography in Patients with Acute Respiratory Failure Who Admitted to Micu
Author Block: C. Lee, E. Kim, L. Sang Hoon, Y. Lee, J. Park, H. Yoon, J. Lee, L. Choon-Taek, Y. Cho; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea, Republic of.
Background: Traditionally, simple chest x-ray (CXR) is the most frequent radiologic investigation performed on patients in intensive care unit (ICU) even though its questionable clinical value. Instead, the frequency of computed tomography (CT) has remarkably increased, however, there are also critical risks of CT, such as patient’s safety during transportation and contrast dye induced nephropathy, especially in patients with acute respiratory failure. We investigated the clinical benefits and risks of CT for acute respiratory failure. Methods: We retrospectively reviewed 164 CT cases of 88 patients from January 2015 to February 2017. We defined the clinical benefits as CT would change the clinical management or would exclude possible diagnosis and the clinical risks as patients had increased oxygen demand or increased critical medications during transportation, also occurrence of acute kidney injury. Each criteria of benefits and risks was scored out of 10 points, and the criteria were weighted to indicate their relative importance. Results: Multi criteria decision analysis showed that 102 cases of all CTs have positive clinical value but 62 cases have negative value. But chest CT except angiography CT, there were 22 cases of positive value and 34 cases have negative value. In aspect of patients, 41 patient have benefits due to CT, and 47 patient have risks due to CT. Conclusions: Our investigation shows that CT can detect many problems more sensitive than CXR. But there were also risks of CT, like contrast dye induced nephropathy, desaturation events and hypotension during transport. Nevertheless some patients gain the benefits by taking a CT scan. So the real clinical values of CT should be considered in ICU patients with acute respiratory failure weighting their benefits and risks.
Author Block: C. Lee, E. Kim, L. Sang Hoon, Y. Lee, J. Park, H. Yoon, J. Lee, L. Choon-Taek, Y. Cho; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea, Republic of.
Background: Traditionally, simple chest x-ray (CXR) is the most frequent radiologic investigation performed on patients in intensive care unit (ICU) even though its questionable clinical value. Instead, the frequency of computed tomography (CT) has remarkably increased, however, there are also critical risks of CT, such as patient’s safety during transportation and contrast dye induced nephropathy, especially in patients with acute respiratory failure. We investigated the clinical benefits and risks of CT for acute respiratory failure. Methods: We retrospectively reviewed 164 CT cases of 88 patients from January 2015 to February 2017. We defined the clinical benefits as CT would change the clinical management or would exclude possible diagnosis and the clinical risks as patients had increased oxygen demand or increased critical medications during transportation, also occurrence of acute kidney injury. Each criteria of benefits and risks was scored out of 10 points, and the criteria were weighted to indicate their relative importance. Results: Multi criteria decision analysis showed that 102 cases of all CTs have positive clinical value but 62 cases have negative value. But chest CT except angiography CT, there were 22 cases of positive value and 34 cases have negative value. In aspect of patients, 41 patient have benefits due to CT, and 47 patient have risks due to CT. Conclusions: Our investigation shows that CT can detect many problems more sensitive than CXR. But there were also risks of CT, like contrast dye induced nephropathy, desaturation events and hypotension during transport. Nevertheless some patients gain the benefits by taking a CT scan. So the real clinical values of CT should be considered in ICU patients with acute respiratory failure weighting their benefits and risks.
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