• L Weidhase, L Mende, J de Fallois, and S Petros.
• Interdisziplinäre Internistische Intensivmedizin, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
• Med Klin Intensivmed Notfmed. 2013 Oct 1;108(7):584-7.

BackgroundRoutine chest radiography (X-ray) after percutaneous dilatational tracheostomy has been considered standard procedure in the past. However, recent observations show this to be unnecessary and cost ineffective. Prospective randomised trials have been lacking.Patient And MethodsCritically ill patients admitted to an ICU with an indication for a percutaneous tracheostomy were consecutively randomized into group 1 (routine postprocedural chest X-ray) and group 2 (chest X-ray only when considered clinically indicated). Tracheostomy was performed under bronchoscopic guidance.ResultsA total of 100 patients (50 per group) were included. Three major complications were observed in group 1 and one presumed complication in group 2. There were 11 minor complications in group 1 and 16 in group 2. Routine chest X-ray in group 1 did not reveal any abnormality related to the tracheostomy. A control chest X-ray was considered necessary in only one patient in group 2, but with no pathological change observed.ConclusionRoutine chest radiography after a percutaneous dilatational tracheostomy conducted under fibre optic bronchoscopic guidance is probably not useful.

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