Routine daily chest radiographs in mechanically ventilated children: necessary surveillance

PURPOSE OF REVIEW: With the growing availability of bedside point-of-care technologies, an expanding body of evidence questions the necessity of routine daily chest radiographs in pediatric intensive care unit (PICU) patients. Nevertheless, this review illustrates that daily chest imaging continues to yield clinically meaningful information and should not be entirely discontinued. RECENT FINDINGS: Routine daily chest radiographs in the PICU frequently reveal malpositioned devices including central venous catheters, chest tubes, nasogastric tubes, and endotracheal tubes. They may also uncover unanticipated cardiopulmonary abnormalities that warrant changes in management. Moreover, the potential risks of radiation exposure can be mitigated through the use of portable imaging and targeted scanning techniques that limit exposure to essential regions. SUMMARY: Routine daily chest radiographs continue to be a valuable tool for pediatric intensivists and have the potential to identify unexpected complications that can significantly influence patient management. Future research should focus on risk stratifying pediatric patient populations which may benefit from routine chest radiography.