Oxygen saturation and hemodynamic response in critically ill, mechanically ventilated adults during intrahospital transport

Abstract

BACKGROUND: Despite the frequency of intrahospital transport of critically ill patients, little research has been done on this topic and the findings are contradictory. OBJECTIVES: To describe arterial oxygen saturation by pulse oximetry, heart rate, heart rhythm, and systolic blood pressure and equipment problems in critically ill, mechanically ventilated adults during intrahospital transport. METHODS: The sample consisted of 36 critically ill, mechanically ventilated adults who required transport out of the intensive care unit for diagnostic testing or procedures within the hospital. Arterial oxygen saturation, heart rate, heart rhythm, and systolic blood pressure were measured at baseline, at least every 5 minutes during transport to and from the test site and at the test site, and every 5 minutes for 15 minutes after return to the unit. Descriptive statistics were used to analyze the data. RESULTS: Nineteen patients (53%) had clinically important changes in arterial oxygen saturation, heart rate, and/or systolic blood pressure. New cardiac arrhythmias developed in two patients. The clinically important changes occurred most frequently at the test/procedure site. Equipment problems such as monitor power failure and ventilator disconnection occurred during transport of 4 patients (11%). Total time out of ICU averaged 62 +/- 30 (range = 26 to 166) minutes. CONCLUSIONS: Transport outside the intensive care unit places the critically ill patient at additional risk. Although transport is often unavoidable, its risks versus benefits should be carefully and collaboratively evaluated for every patient prior to making the decision for transport.

Unexpected Events during the Intrahospital Transport of Critically Ill Patients

“…The inverse relationship between physician experience and UE/SUE rates is consistent with Evans and Winslow. 16 However, we are unable to determine the reasons for this relationship. It may relate to the quality of care provided, reporting bias, or confounders (e.g., patient selection).…”

Downward movement of syringe pumps reduces syringe output

“…Changes in¯ow of vasoactive drugs may contribute to the haemodynamic instability often seen when moving intensive care patients. 7 Relevant time without infusion was found up to infusion rates of >5 ml h ±1 . The greater compliance of the Ivac 770 system in¯uenced the marked effect of changes in out¯ow pressure on this apparatus.…”

Fatores associados à hipotermia durante o transporte intra-hospitalar em pacientes internados em Unidade de Terapia Intensiva Neonatal

“…The frequency of clinical complications in this study was elevated, similar to the report for interhospital transports of newborn infants published by Lim and Ratnavel (12) . Other studies have also reported elevated rates of clinical problems during intrahospital transports of adults and children, varying from six to 71% (1,2,13,15,(18)(19)(20) , indicating that the risk of morbidity in intrahospital transports may be comparable with the risk SNC: central nervous system; O 2 : oxygen; Hosmer-Lemeshow test: 0.633, p<0.001. MV: mechanical ventilation.…”