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dc.contributor.authorLazarus, Matthew S
dc.contributor.authorHossain, Rydhwana
dc.contributor.authorVillasana, Geraldine M
dc.contributor.authorHerring, Allison A
dc.contributor.authorYe, Kenny
dc.contributor.authorJeudy, Jean
dc.contributor.authorLevsky, Jeffrey M
dc.contributor.authorWhite, Charles S
dc.contributor.authorHaramati, Linda B
dc.date.accessioned2022-06-23T20:02:30Z
dc.date.available2022-06-23T20:02:30Z
dc.date.issued2022-06-16
dc.identifier.urihttp://hdl.handle.net/10713/19255
dc.description.abstractPurpose: Prone position is known to improve acute lung injury, and chest radiographs are often necessary to monitor disease and confirm support device placement. However, there is a paucity of literature regarding radiographs obtained in this position. We evaluated prone radiographs for distinguishing features and ability to identify support devices. Methods: Pairs of prone and supine radiographs obtained during the COVID-19 pandemic were assessed retrospectively. IRB approval and waiver of informed consent were obtained. Radiographs were assessed for imaging adequacy, distinguishing features, and support device identification (endotracheal tube, enteric tube, or central line). Radiographs were reviewed by ≥ 2 cardiothoracic radiologists. Results: Radiographs from 81 patients (63yo ± 13, 30% women) were reviewed. Prone and supine radiographs were comparable for imaging the lung bases (81% vs. 90%, p = 0.35) and apices (93% vs. 94%, p = 1); prone radiographs more frequently had significant rotation (36% vs. 19%, p = 0.021). To identify prone technique, scapula tip located beyond the rib border was 89% sensitive (95%CI 80-95%) and 85% specific (76-92%), and a fundal stomach bubble was 44% sensitive (33-56%) and 90% specific (81-96%). For women, displaced breast shadow was 46% sensitive (26-67%) and 92% specific (73-99%). Prone and supine radiographs each identified > 99% of support devices. Prone exams trended toward increased rate of malpositioned device (12% vs. 6%, p = 0.07). Conclusion: Scapula position reliably distinguishes prone from supine position; fundal stomach bubble or displaced breast shadow is specific for prone position. Prone radiographs reliably identify line and tube position, which is particularly important as prone patients appear at increased risk for malpositioned devices.en_US
dc.description.urihttps://doi.org/10.1007/s00408-022-00545-yen_US
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.relation.ispartofLungen_US
dc.rights© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.en_US
dc.subjectCOVID-19en_US
dc.subjectChest radiographyen_US
dc.subjectCritical careen_US
dc.subjectProne positionen_US
dc.titleProne Chest Radiographs: Distinguishing Features and Identification of Support Devices.en_US
dc.typeArticleen_US
dc.identifier.doi10.1007/s00408-022-00545-y
dc.identifier.pmid35708780
dc.source.journaltitleLung
dc.source.countryUnited States


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