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Erschienen in: Intensive Care Medicine 2/2004

01.02.2004 | Neonatal and Pediatric Intensive Care

Comparison of interhospital pediatric intensive care transport accompanied by a referring specialist or a specialist retrieval team

verfasst von: Gijs D. Vos, Annemieke C. Nissen, Fred H.M.Nieman, Mieke M. B. Meurs, Dick A. van Waardenburg, Graham Ramsay, Raymond A. M. G. Donckerwolcke

Erschienen in: Intensive Care Medicine | Ausgabe 2/2004

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Abstract

Objective

Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups.

Design and setting

Prospective observational clinical study in pediatric intensive care units of Dutch university hospitals.

Patients

249 pediatric patients requiring interhospital intensive care transport.

Methods

Data were collected on interhospital pediatric intensive care transports. We compared patient characteristics, interventions before and directly after transport, complications and equipment available during transport (137 accompanied by referring specialists, 112 by specialist retrieval teams).

Results

Interhospital transports accompanied by referring specialists had a longer average transport time (74.6 vs. 60.2 min), higher incidence of respiratory insufficiency (56.9% vs. 41.1%), and lower incidence of circulatory insufficiency (27.0% vs. 41.1%) than primary admission diagnoses. These transports had a lower percentage of ventilatory support (47.4% vs. 72.3%), higher need for acute interventions directly upon arrival on the pediatric ICU, and higher incidence of critical and serious complications. In 75% of the transfers accompanied by retrieval teams interventions before the transport were deemed to be necessary. During the transports accompanied by referring specialists the equipment and materials available proved rather limited.

Conclusions

During pediatric intensive care transports accompanied by nontrained referring specialists there appears to be a higher incidence of complications, specialized equipment is more often not available, and more acute interventions are required upon arrival in the pediatric ICU.
Literatur
1.
Zurück zum Zitat Pearson G, Shann F, Barry P, Vyas J, Thomas D, Powell C, Field D (1997) Should paediatric intensive care be centralised? Trent versus Victoria. Lancet 349:1213–1217CrossRef Pearson G, Shann F, Barry P, Vyas J, Thomas D, Powell C, Field D (1997) Should paediatric intensive care be centralised? Trent versus Victoria. Lancet 349:1213–1217CrossRef
2.
Zurück zum Zitat Pollack MM, Alexander SR, Clarke N, Ruttimann UE, Tesselaar HM, Bachulis AC (1991) Improved outcomes from tertiary center pediatric intensive care: a statewide comparison of tertiary and nontertiary care facilities. Crit Care Med 19:150–159CrossRef Pollack MM, Alexander SR, Clarke N, Ruttimann UE, Tesselaar HM, Bachulis AC (1991) Improved outcomes from tertiary center pediatric intensive care: a statewide comparison of tertiary and nontertiary care facilities. Crit Care Med 19:150–159CrossRef
3.
Zurück zum Zitat Gemke RJ, Bonsel GJ (1995) Comparative assessment of pediatric intensive care: a national multicenter study. Pediatric Intensive Care Assessment of Outcome (PICASSO) Study Group. Crit Care Med 23:238–245CrossRef Gemke RJ, Bonsel GJ (1995) Comparative assessment of pediatric intensive care: a national multicenter study. Pediatric Intensive Care Assessment of Outcome (PICASSO) Study Group. Crit Care Med 23:238–245CrossRef
4.
Zurück zum Zitat Gemke RJ (1997) Centralisation of paediatric intensive care to improve outcome. Lancet 349:1187–1188CrossRef Gemke RJ (1997) Centralisation of paediatric intensive care to improve outcome. Lancet 349:1187–1188CrossRef
5.
Zurück zum Zitat Goh AY, Abdel-Latif Mel A, Lum LC, Abu-Bakar MN (2003) Outcome of children with different accessibility to tertiary pediatric intensive care in a developing country-a prospective cohort study. Intensive Care Med 29:97–102CrossRef Goh AY, Abdel-Latif Mel A, Lum LC, Abu-Bakar MN (2003) Outcome of children with different accessibility to tertiary pediatric intensive care in a developing country-a prospective cohort study. Intensive Care Med 29:97–102CrossRef
6.
Zurück zum Zitat Barry PW, Ralston C (1994) Adverse events occurring during interhospital transfer of the critically ill. Arch Dis Child 71:8–11CrossRef Barry PW, Ralston C (1994) Adverse events occurring during interhospital transfer of the critically ill. Arch Dis Child 71:8–11CrossRef
7.
Zurück zum Zitat Britto J, Nadel S, Maconochie I, Levin M, Habibi P (1995) Morbidity and severity of illness during interhospital transfer: impact of a specialised paediatric retrieval team. BMJ 311:836–839CrossRef Britto J, Nadel S, Maconochie I, Levin M, Habibi P (1995) Morbidity and severity of illness during interhospital transfer: impact of a specialised paediatric retrieval team. BMJ 311:836–839CrossRef
8.
Zurück zum Zitat Bellingan G, Olivier T, Batson S, Webb A (2000) Comparison of a specialist retrieval team with current United Kingdom practice for the transport of critically ill patients. Intensive Care Med 26:740–744CrossRef Bellingan G, Olivier T, Batson S, Webb A (2000) Comparison of a specialist retrieval team with current United Kingdom practice for the transport of critically ill patients. Intensive Care Med 26:740–744CrossRef
9.
Zurück zum Zitat Booy R, Habibi P, Nadel S, de Munter C, Britto J, Morrison A, Levin M (2001) Reduction in case fatality rate from meningococcal disease associated with improved healthcare delivery. Arch Dis Child 85:386–390CrossRef Booy R, Habibi P, Nadel S, de Munter C, Britto J, Morrison A, Levin M (2001) Reduction in case fatality rate from meningococcal disease associated with improved healthcare delivery. Arch Dis Child 85:386–390CrossRef
10.
Zurück zum Zitat Britto J, Nadel S, Levin M, Habibi P (1995) Mobile paediatric intensive care: the ethos of transferring critically ill children. Care Critically Ill 11:235–238 Britto J, Nadel S, Levin M, Habibi P (1995) Mobile paediatric intensive care: the ethos of transferring critically ill children. Care Critically Ill 11:235–238
11.
Zurück zum Zitat Tibby SM, Taylor D, Festa M, Hanna S, Hatherill M, Jones G, Habibi P, Durward A, Murdoch IA (2002) A comparison of three scoring systems for mortality risk among retrieved intensive care patients. Arch Dis Child 87:421–425CrossRef Tibby SM, Taylor D, Festa M, Hanna S, Hatherill M, Jones G, Habibi P, Durward A, Murdoch IA (2002) A comparison of three scoring systems for mortality risk among retrieved intensive care patients. Arch Dis Child 87:421–425CrossRef
12.
Zurück zum Zitat Dockery WK, Futterman C, Keller SR, Sheridan MJ, Akl BF (1999) A comparison of manual and mechanical ventilation during pediatric transport. Crit Care Med 27:802–806CrossRef Dockery WK, Futterman C, Keller SR, Sheridan MJ, Akl BF (1999) A comparison of manual and mechanical ventilation during pediatric transport. Crit Care Med 27:802–806CrossRef
Metadaten
Titel
Comparison of interhospital pediatric intensive care transport accompanied by a referring specialist or a specialist retrieval team
verfasst von
Gijs D. Vos
Annemieke C. Nissen
Fred H.M.Nieman
Mieke M. B. Meurs
Dick A. van Waardenburg
Graham Ramsay
Raymond A. M. G. Donckerwolcke
Publikationsdatum
01.02.2004
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 2/2004
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-2066-7

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