Background
Methods
Patients
Methods
IHT
Data collection
Data analysis
Results
Patients
All patients (n = 184) | Median | [25th-75thpercentiles] | Number | % |
---|---|---|---|---|
Characteristics of patients
| ||||
Age (yr) | 58 | [48–71] | ||
Man | 129 | 70.1 | ||
SAPS II | 48 | [34–62] | ||
COPD | 26 | 14 | ||
ALI | 125 | 68 | ||
ARDS | 56 | 30.4 | ||
Characteristics of hospitalization in ICU
| ||||
Length of stay in ICU (days) | 16 | [8.25-25.75] | ||
Length of mechanical ventilation (days) | 11 | [6–21.75] | ||
Dialysis during hospitalization | 48 | 26 | ||
Ventilator-associated pneumonia | 56 | 30.4 | ||
Death Day 28 | 55 | 29.9 | ||
Death in ICU | 69 | 37.5 |
All intrahospital transports (n = 262) | Median | [25th-75thpercentiles] | Number | % |
---|---|---|---|---|
Characteristics of patients before IHT
| ||||
SOFA the day of IHT |
5
| |||
Endotracheal tube |
262
|
100
| ||
Orotracheal tube | 169 | 64.5 | ||
Nasotracheal tube | 64 | 24.4 | ||
Tracheotomy | 29 | 11.1 | ||
Central venous catheter |
220
|
84
| ||
Subclavian vein | 148 | 56.5 | ||
Internal jugular vein | 23 | 8.8 | ||
Femoral vein | 49 | 18.7 | ||
Arterial line
|
197
|
75.2
| ||
Radial | 159 | 60.7 | ||
Femoral | 38 | 14.5 | ||
Nasogastric tube |
242
|
92.4
| ||
Urinary catheter |
255
|
97.3
| ||
Chest tube |
35
|
13.4
| ||
Inhaled nitric oxide |
4
|
1.5
| ||
Ventilatory mode before IHT | ||||
VAC | 214 | 81.7 | ||
BIPAP | 18 | 6.9 | ||
PSV | 27 | 10.7 | ||
FiO2 before IHT (%) |
45
|
[35–60]
| ||
PEEP before IHT (cmH
2
O) |
6
| |||
Treatments before IHT | ||||
Sedation | 153 | 58.4 | ||
Neuromuscular blocker | 27 | 10.3 | ||
Norepinephrine | 45 | 17.2 | ||
Dobutamine | 32 | 12.2 | ||
Epinephrine | 4 | 1.5 | ||
Characteristics of patients during IHT
| ||||
Number of infusion pumps |
2
| |||
Duration of CT scan (min) |
30
|
[20–40]
| ||
Duration of transport (min) |
50
|
[40–60]
| ||
Ventilatory mode during transport | ||||
VAC | 249 | 95.0 | ||
PSV | 13 | 5.0 | ||
Ventilatory parameters during transport | ||||
Ventilatory mode change for transport | 35 | 13.4 | ||
FiO2 during IHT (%) | 100 | [50–100] | ||
PEEP during IHT (cmH2O) | 6 | |||
Change of PEEP for transport | 23 | 8.8 | ||
Treatment modification for transport |
59
|
22.5
| ||
Sedation for transport | 38 | 14.5 | ||
Neuromuscular blocker use for transport | 16 | 6.1 | ||
Fluid challenge for transport | 12 | 4.6 | ||
Junior physician accompanying IHT | ||||
Junior physician with experience | 144 | 60 | ||
Junior anesthetist physician | 121 | 50.4 |
Recorded adverse events
All intrahospital transports (n = 262) | Number | % |
---|---|---|
Adverse events during transport
|
120
|
45.8
|
Patient-related adverse events during transport
|
68
|
26
|
Major patient-related adverse events during transport |
44
|
16.8
|
Oxygen desaturation | 23 | 8.8 |
Extubation | 1 | 0.4 |
Accidental central venous catheter removal | 1 | 0.4 |
Hemodynamic instability | 13 | 5 |
Increased vasopressor dose | 5 | 1.9 |
Minor patient-related adverse events during transport |
53
|
20.2
|
Agitation | 38 | 14.5 |
Accidental nasogastric tube pull out | 1 | 0.4 |
Vomiting | 3 | 1.1 |
Peripheral venous catheter incident | 4 | 1.5 |
Central venous catheter incident | 6 | 2.3 |
Arterial line incident | 5 | 1.9 |
Accidental dislodging of urinary catheter | 1 | 0.4 |
Disconnection of endotracheal tube and airway equipment | 2 | 0.8 |
Equipment-related incidents during transport
|
86
|
32.8
|
Incident with airway equipment (alarm, adjustment) | 46 | 17.6 |
Incident with monitor (battery, alarm) | 45 | 17.2 |
Incident with infusion pumps (battery, alarm) | 18 | 6.9 |
Risk assessment before transport
Total adverse events
Qualitative data | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
OR (95% CI) |
p
| OR (95% CI) |
p
| |
Treatments before transport
| ||||
Dialysis | 0.76 (0.44-1.32) | NS | ||
Sedation | 2.02 (1.22-3.34) | 0.008 | 1.85 (1.1-3.11) | 0.021 |
Neuromuscular blockers use | 1.55 (0.69-3.45) | NS | ||
Norepinephrine before transport | 1.61 (0.84-3.06) | NS | ||
Dobutamine before transport | 1.21 (0.58-2.54) | NS | ||
Ventilatory mode before IHT
| ||||
VAC | 0.9 (0.48-1.69) | NS | ||
BIPAP | 0.94 (0.36-2.47) | NS | ||
PSV | 1.42 (0.65-3.11) | NS | ||
FiO2 before IHT >60% | 1.51 (0.81-2.83) | NS | ||
PEEP before IHT >6 cmH2O | 2.27 (1.34-3.85) | 0.003 | 2.28 (1.32-3.95) | 0.003 |
Transport
| ||||
More than four infusion pumps for transport | 3.4 (0.88-13.03) | 0.071 | NS | |
Ventilatory mode change for transport | 1.3 (0.64-2.65) | NS | ||
Change of PEEP for transport | 0.84 (0.05-13.64) | NS | ||
Treatment modification for transport | 2.22 (1.23-4.01) | 0.011 | NS | |
Sedation for transport | 1.77 (0.88-3.55) | NS | ||
Neuromuscular blocker use for transport | 1.2 (0.44-3.29) | NS | ||
Fluid challenge for transport | 6.36 (1.37-29.64) | 0.014 | 6.48 (1.32-31.69) | 0.021 |
Quantitative data
|
Univariate
|
Multivariate
| ||
Without AE
|
With AE
|
analysis
|
analysis
| |
Patient data (Med (25
th
,75
th
))
| ||||
Age (yr) | 61 (44–74) | 58 (50.5-68) | NS | |
SAPS II | 48 (34–61) | 48 (34–64) | NS | |
Transport's data (Med (25
th
,75
th
))
| ||||
SOFA the day of transport | NS | |||
MV duration before transport (days) | 4 [2–11.25] | 4 [2–10.75] | NS | |
No. of infusion pumps during transport | p = 0.015 | NS |
Patient-related adverse events
Qualitative data | Univariate analysis | |||
---|---|---|---|---|
OR (95% CI) |
p
| OR (95% CI) |
p
| |
Treatments before transport
| ||||
Dialysis | 0.84 (0.45-1.58) | NS | ||
Sedation | 1.48 (0.83-2.61) | NS | ||
Neuromuscular blockers use | 0.78 (0.3-2.02) | NS | ||
Norepinephrine before transport | 1.71 (0.86-3.39) | NS | ||
Dobutamine before transport | 1.11 (0.49-2.53) | NS | ||
Ventilatory mode before IHT
| ||||
VAC | 1.09 (0.53-2.24) | NS | ||
BIPAP | 1.44 (0.52-3.99) | NS | ||
PSV | 0.74 (0.29-1.91) | NS | ||
FiO2 before IHT > 60% | 1.52 (0.77-2.99) | NS | ||
PEEP before IHT > 6 cmH2O | 2.16 (1.22-3.81) | 0.01 | 2.11 (1.17-3.8) | 0.01 |
Transport
| ||||
More than four infusion pumps for transport | 1.07 (0.28-4.17) | NS | ||
Ventilatory mode change for transport | 1.14 (0.52-2.51) | NS | ||
Change of PEEP for transport | 0.76 (0.27-2.13) | NS | ||
Treatment modification for transport | 2.66 (1.44-4.91) | 0.002 | 2.81 (1.5-5.3) | 0.001 |
Sedation for transport | 3.05 (1.5-6.21) | 0.003 | NS | |
Neuromuscular blocker use for transport | 0.93 (0.29-2.98) | NS | ||
Fluid challenge for transport | 2.97 (0.92-9.54) | 0.087 | NS | |
Quantitative data
|
Without AE
|
With AE
|
Univariate analysis (
p
)
| |
Patient data (Med (25th ,75th))
| ||||
Age (yr) | 57.5 [46–71.25] | 59.5 [50.75-69.5] | NS | |
SAPS II | 47 [34–61.5] | 49 [34–64] | NS | |
Transport data (average ± SD)
| ||||
SOFA the day of transport | 5 [3–8.75] | NS | ||
MV duration before transport (days) | 4.5 [2–12.25] | 3.5 [2–9.75] | NS | |
No. of infusion pumps during transport | NS |