ICU Chest Films > Normal ICU Series

Normal ICU Series

In the first few days after CABG, up to 75% of patients experience a degree of left lower lobe atelectasis, bilateral in about 20%. This normally resolves within a few days without complications. The mediastinal contour may be slightly wide, and any significant increase in diameter might reflect mediastinal bleeding. A small pleural effusion can be expected but again, it is important to recognize any increase in size of the effusion as it may compromise the patientâs ability to ventilate and oxygenate. Up to 50% of patients have a pleural effusion after abdominal surgery. Comparison with the prior exam is important to determine whether the condition is improving or deteriorating.

Chest radiographs taken on post-operative day 3 and 5, respectively, demonstrate worsening left lower lobe atelectasis and effusion.

As the patient's condition improves, the endotracheal tube, chest tubes and mediastinal drains are removed. A film is usually obtained to ensure that a pneumothorax has not occurred after chest tube removal. Usually by this time, the atelectasis has resolved and so has any fluid overload. The patient is discharged with follow up.

Patient at discharge with endotracheal tube and pulmonary capillary wedge pressure monitor removed and resolution of pleural effusion and atelectasis.

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