Utilization of conventional radiography in a regional neonatal intensive care unit in Ireland

Abstract

Objective: To audit the demand and radiation exposure of conventional radiography in a regional neonatal intensive care unit (NICU) in Ireland.

Methods: A retrospective study of radiographs performed on all admissions to the NICU in University Maternity Hospital Limerick (UMHL) over 2 years.

Results: A total of 1405 radiographs were performed on 506 infants. 153.5 radiographs per 1000 live births was the observed demand and 44% of radiographs were done out of hours. 47% of all radiographs were performed on infants <1500 g. Median number of radiographs per infant was one (IQR 1–2; range 1–39). Significant negative correlation was observed between number of radiographs and gestational age. Mean lung radiation doses estimated using published values for normal weight (>2500 g), very low birth weight (VLBW), and extremely low birth weight (ELBW) infants based on the median number of chest X-rays were 31.7 µGym, 84.66 and 232.75 µGy, respectively.

Conclusions: Conventional radiography remains a key diagnostic tool in neonatology particularly in VLBW and ELBW infants and is invaluable in supporting timely clinical decision making. Clinicians should be aware of the cost and potential hazards of neonatal radiography and is recommend that the cumulative radiation exposure among the ELBW and VLBW infants is monitored. Increasing awareness and standardisation of point-of-care ultrasonography could decrease the reliance on conventional radiography in neonatal units.

Keywords:

• Neonatal intensive care unit (NICU)
• X-ray
• radiation
• very low birth weight (VLBW)
• extremely low birth weight (ELBW)
• health economics
• point-of-care ultrasonography

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Acknowledgements

Authors wish to acknowledge the support from radiographers for their prospective data source compiling, Ms. Colette Quinn, Senior Neonatal Nurse for acting as an information source for the clinical data of VLBW and ELBW infants and Ms. Louise Reid, Audit officer, for the advice on audit process.

Disclosure statement

The authors declare that they have no conflict of interest.