Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019;31(1):15-20.
doi: 10.5935/0103-507X.20190003. Epub 2019 Feb 28.

Adverse events during intrahospital transport of critically ill patients in a large hospital

[Article in Portuguese, English]
Viviane Cordeiro Veiga  1   2 , Natalia Fioravanti Postalli  2 , Thais Kawagoe Alvarisa  2 , Phillipe Pereira Travassos  2 , Raquel Telles da Silva Vale  2 , Cleyton Zanardo de Oliveira  3 , Salomón Soriano Ordinola Rojas  1   2
Affiliations

Adverse events during intrahospital transport of critically ill patients in a large hospital

[Article in Portuguese, English]
Viviane Cordeiro Veiga et al. Rev Bras Ter Intensiva. 2019.

Abstract
in English, Portuguese

Objective: To describe the incidence of clinical and non-clinical events during intrahospital transport of critically ill patients and to analyze the associated risk factors.

Methods: Cohort study with retrospective data collected from October 2016 to October 2017. All cases of intrahospital transport for diagnostic and therapeutic purposes in a large hospital with six adult intensive care units were analyzed, and the adverse events and related risk factors were evaluated.

Results: During the study period, 1,559 intrahospital transports were performed with 1,348 patients, with a mean age of 66 ± 17 years and a mean transport time of 43 ± 34 minutes. During transport, 19.8% of the patients were using vasoactive drugs; 13.7% were under sedation; and 10.6% were under mechanical ventilation. Clinical events occurred in 117 transports (7.5%), and non-clinical events occurred in 125 (8.0%) transports. Communication failures were prevalent; however, the multivariate analysis showed that the use of sedatives, noradrenaline and nitroprusside and a transport time greater than 36.5 minutes were associated with adverse clinical events. The use of dobutamine and a transport time greater than 36.5 minutes were associated with non-clinical events. At the end of transport, 98.1% of the patients presented unchanged clinical conditions compared with baseline.

Conclusion: Intrahospital transport is related to a high incidence of adverse events, and transport time and the use of sedatives and vasoactive drugs were related to these events.

Objetivo: Descrever a incidência de eventos clínicos e não clínicos durante o transporte intra-hospitalar de pacientes críticos e analisar os fatores de risco associados.

Métodos: Estudo de coorte, com coleta retrospectiva, no período de outubro de 2016 a outubro de 2017, tendo sido analisados todos os transportes intra-hospitalares para fins diagnósticos e terapêuticos em hospital de grande porte, que contava com seis unidades de terapia intensiva adulto, sendo avaliados os eventos adversos e os fatores de risco relacionados.

Resultados: No período, foram realizados 1.559 transportes intra-hospitalares, em 1.348 pacientes, com média de idade de 66 ± 17 anos, tempo médio de transporte de 43 ± 34 minutos. Durante o transporte, 19,8% dos pacientes estavam em uso de drogas vasoativas; 13,7% em uso de sedativos e 10,6% estavam sob ventilação mecânica. Eventos clínicos ocorreram em 117 transportes (7,5%) e não clínicos em 125 transportes (8,0%). Falhas de comunicação foram prevalentes, no entanto, aplicando-se análise multivariada, uso de sedativos, noradrenalina e nitroprussiato, e o tempo de transporte maior que 36,5 minutos estiveram associados a eventos adversos clínicos. Uso de dobutamina e tempo de transporte superior a 36,5 minutos estiveram associados a eventos não clínicos. Ao final do transporte, 98,1% dos pacientes apresentaram condições clínicas inalteradas em relação ao seu estado basal.

Conclusão: Transportes intra-hospitalares estão relacionados à alta incidência de eventos adversos; o tempo de transporte e a utilização de sedativos e drogas vasoativas estiveram relacionados a esses eventos.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None.

References

    1. Blakeman TC, Branson RD. Inter- and intra-hospital transport of the critically ill. Respir Care. 2013;58(6):1008–1023. - PubMed
    1. Pedreira LC, Santos IM, Farias MA, Sampaio ES, Barros CS, Coelho AC. Nurses' knowledge of intra-hospital transport of critical patients. Rev Enferm UERJ. 2014;22(4):533–539.
    1. Kue R, Brow P, Ness C, Scheulen J. Adverse clinical events during intrahospital transport by a specialized team: a preliminary report. Am J Crit Care. 2011;20(2):153–161. quiz 162. - PMC - PubMed
    1. Jia L, Wang H, Gao Y, Liu H, Yu K. High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: a prospective, multicenter study in China. Crit Care. 2016;20:12–12. - PMC - PubMed
    1. Almeida AC, Neves AL, Souza CL, Garcia JH, Lopes JL, Barros AL. Intra-hospital transport of critically ill adult patients: complications related to staff, equipment and physiological factors. Acta Paul Enferm. 2012;25(3):471–476.

MeSH terms