A comparison of manual and mechanical ventilation during pediatric transport.
OBJECTIVE
To compare the amount of variability in ventilation during intrahospital transport of intubated pediatric patients ventilated either manually or with a transport ventilator.


METHODS
Prospective, randomized study.


METHODS
Tertiary, multidisciplinary, pediatric intensive care unit.


METHODS
Forty-nine pediatric postoperative heart patients who required transport while still intubated.


METHODS
Patients were randomized to receive either manual ventilation during transport or ventilation by a portable mechanical ventilator. Baseline ventilatory and hemodynamic parameters were recorded before and during transport. Before and after arterial blood gases were also obtained. All other aspects of care were identical.


RESULTS
There was a statistically significant greater amount of variation in ventilation during transport with manual technique as opposed to the mechanical ventilator. A Student's t-test on pre- to post-blood gas differences showed a significantly lower PetCO2 (p = .02) in the manually ventilated patients when compared with the mechanically ventilated patients. Values for PCO2 were higher, but only marginally significant (p = .08). Repeated measures analysis of variance using these same pre- and post blood gas values confirmed the significant decrease in PetCO2 (p = .05). Minute to minute variation in PetCO2 during transport was greater and the mean values significantly lower in the manually ventilated group (p < .05). Hemodynamic data were remarkably stable when examined both before and after transport and on a minute to minute basis during transport.


CONCLUSIONS
Manual ventilation during intrahospital transport results in greater fluctuation of ventilatory parameters from an established baseline than does use of a transport ventilator. No clinically significant changes in status occurred during the brief period of transport studied.
D000293:Adolescent; D000704:Analysis of Variance; D001784:Blood Gas Analysis; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010360:Patient Transfer / Q000379:methods; D011182:Postoperative Care; D011446:Prospective Studies; D012123:Pulmonary Ventilation; D012121:Respiration, Artificial / Q000379:methods*; D012720:Severity of Illness Index; D014187:Transportation of Patients / Q000379:methods; D014768:Virginia