Endotracheal tube repositioning based on measurement at the incisors is inaccurate and the magnitude of the intervention does not correlate with the degree of error. Repositioning of endotracheal tubes based on measurements at the incisors should be abandoned; if not abandoned, follow-up chest radiograph images are recommended [35]. Routine daily imaging of patients with tracheostomy in an ICU provides little clinical utility, and chest radiographs in this population should be performed selectively based on the patient's clinical status. In one study of 761 chest radiographs, only 18 (2.3%) radiographs revealed new complications [36]. All complications were clinically suspected prior to imaging. Only 5 (0.7%) complications resulted in a management change. The most common management changes were a change in antibiotic regimen (0.3%) and ordering of diuretics (0.3%) [36]. Studies evaluating the efficacy of deep learning systems with deep convolutional neural networks were accurate to detect presence versus absence of an endotracheal tube, but deep convolutional neural networks did not perform as well and achieved only reasonable accuracy for differentiating low versus normal positioning of the endotracheal tube [37]. Central Venous Catheter Eight studies were reviewed regarding CVC [24-26,28-30,32,34]. The majority came to the same conclusion: chest radiographs following catheter insertion are useful, with approximately 10% of the chest radiographs demonstrating Intensive Care Unit Patients malpositioned catheters. Pneumothoraces were present in only a small percentage of patients. Gray et al [24] separated jugular and subclavian catheters. Complications were twice as common with subclavian catheters (17% versus 8%), although unsuspected complications were infrequent.
Intensive Care Unit Patients. Endotracheal tube repositioning based on measurement at the incisors is inaccurate and the magnitude of the intervention does not correlate with the degree of error. Repositioning of endotracheal tubes based on measurements at the incisors should be abandoned; if not abandoned, follow-up chest radiograph images are recommended [35]. Routine daily imaging of patients with tracheostomy in an ICU provides little clinical utility, and chest radiographs in this population should be performed selectively based on the patient's clinical status. In one study of 761 chest radiographs, only 18 (2.3%) radiographs revealed new complications [36]. All complications were clinically suspected prior to imaging. Only 5 (0.7%) complications resulted in a management change. The most common management changes were a change in antibiotic regimen (0.3%) and ordering of diuretics (0.3%) [36]. Studies evaluating the efficacy of deep learning systems with deep convolutional neural networks were accurate to detect presence versus absence of an endotracheal tube, but deep convolutional neural networks did not perform as well and achieved only reasonable accuracy for differentiating low versus normal positioning of the endotracheal tube [37]. Central Venous Catheter Eight studies were reviewed regarding CVC [24-26,28-30,32,34]. The majority came to the same conclusion: chest radiographs following catheter insertion are useful, with approximately 10% of the chest radiographs demonstrating Intensive Care Unit Patients malpositioned catheters. Pneumothoraces were present in only a small percentage of patients. Gray et al [24] separated jugular and subclavian catheters. Complications were twice as common with subclavian catheters (17% versus 8%), although unsuspected complications were infrequent.