THE IMPORTANCE OF A MOBILE X-RAY DEVICE IN ICU

Abstract

Mobile X-ray is one of the most important diagnostic technologies available in the intensive care unit (ICU). Its primary value stems from the ability to perform radiological assessment at the bedside, without transferring a hemodynamically, respiratoryly, or neurologically unstable patient to the radiology department. For the intensivist, mobile radiography is not just a technical procedure, but part of the daily decision-making process: it can quickly verify the position of the endotracheal tube, central venous catheter, nasogastric tube, and chest drain, recognize pneumothorax, atelectasis, pleural effusion, pulmonary edema, or progression of infiltrates, and assess the consequences of intervention. The American College of Radiologists guidelines state that portable chest radiography is an appropriate initial method in the ICU in appropriate clinical circumstances, especially after deterioration of the condition or placement of new tubes and catheters (1). At the same time, mobile X-ray has important limitations: images are most often obtained in the anteroposterior projection, in the supine position, with patient rotation, poor inspiration, and overlapping of numerous medical devices. Therefore, it is not a substitute for computed tomography, lung ultrasound, or clinical assessment. The aim of this paper is to present the importance of mobile X-ray from the perspective of an intensivist, with an emphasis on speed of decision-making, patient safety, diagnostic reach, technical limitations, rational use, and protection from ionizing radiation. In conclusion, the greatest value of mobile X-ray is achieved when the examination is ordered due to a clearly stated clinical question, when it is performed by trained personnel, and when the result is immediately correlated with the clinical findings and other bedside methods.