Condition on arrival of transferred critically ill patients

Abstract

We performed a retrospective inventory of the condition of transferred patients to our 11-bed medical ICU, aimed firstly to measure the quality of these transports and secondly to identify variables that may predict a high risk of deterioration during transferral. By a search in our hospital database, we identified 112 consecutive patients (47 women/65 men) transferred from other hospitals (distance 20-350 km) to our ICU over a period of 14 months. The following data were collected on departure (if available) and on arrival: blood pressure, heart rate, temperature, oxygen saturation, routine laboratory parameters, arterial blood gas analysis, lactic acid, settings of mechanical ventilation, use of vasopressor/inotropic medication, presence of venous and arterial catheters and Apache II score on arrival. No major worsening during transportation was found, looking at the whole group. However, individual data showed severe deterioration of some patients during transport. We were not able to point out parameters that could predict hemodynamic or respiratory instability during transport or condition on arrival. In conclusion, quality of transport seems fairly good; in individual cases, improvements are possible. Therefore, we plan to investigate whether or not a strict protocol, based on recommendations in the literature and on local feasibility can further improve condition on arrival and survival of transferred ICU patients in our adherence region.