Safe long-distance interhospital ground transfer of critically ill patients with acute severe unstable respiratory and circulatory failure.
OBJECTIVE
To assess the safety of long-distance ground interhospital transport of critically ill patients with the most severe unstable respiratory failure after establishment of a dedicated transport system.


METHODS
Cohort study, retrospective chart review in 13 hospitals and intensive care units (ICU) in Finland, and a tertiary referral center and ICU of a university hospital.


METHODS
66 consecutive critically ill patients who were transferred to our ICU from 13 different ICUs in Finland because of severe, progressive respiratory failure, 52 (79%) with acute respiratory distress syndrome.


RESULTS
Major complications during transfer and patients' oxygenation. The median transfer distance was 161 km (range 120-460 km). Drugs for cardiovascular support were infused in 59 patients (89%) during transfer. Fourteen patients (21%) were transferred in prone position because of life-threatening hypoxemia. The ratio of arterial blood PaO(2) and the fraction of oxygen in the ventilator was 8.5+/-2.7 kPa (64+/-20 mmHg) before transfer and 9.7+/-3.6 kPa (73+/-27 mmHg) after transfer. There were no major complications during the transfer. ICU mortality was 30%.


CONCLUSIONS
Long-distance interhospital ground transfer of even critically ill patients with severe unstable respiratory and circulatory failure is safe if a dedicated transport team and a specially equipped transport vehicle are used.
Kuopio University Hospital, Critical Care Research Program, Department of Anesthesiology and Intensive Care, Division of Critical Care, PO Box 1777, 70211, Kuopio, Finland. ari.uusaro@kuh.fi
Ari
A
Uusaro
Ilkka
I
Parviainen
Jukka
J
Takala
Esko
E
Ruokonen
D000328:Adult; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D005387:Finland; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer / Q000592:standards*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy; D012131:Respiratory Insufficiency / Q000150:complications; D012189:Retrospective Studies; D017751:Safety Management; D012769:Shock / Q000150:complications; D014187:Transportation of Patients / Q000592:standards*