The benefit of lateral radiographs in an intensive care unit.

The portable anteroposterior (AP) radiograph (CXR) is an essential component of clinical management in the intensive care unit (ICU). In view of the immobility of patients, and overlying tubes, wires, and catheters, lateral (LAT) CXRs are infrequently ordered. We constructed a portable acrylic (Plexiglas) CXR cassette holder and were able to obtain reproducible quality LAT CXRs in the ICU. Of the 72 simultaneously obtained AP and LAT CXRs, 60 were technically acceptable for interpretation. We found an 11 percent incidence of either unexpected conditions or we were able to improve on the AP CXR interpretation. Lateral CXRs should be obtained routinely in the ICU in select patients.