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


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


METHODS
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.
Vos
Gijs D
GD
Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. gvo@paed.azm.nl.
Nissen
Annemieke C
AC
Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands.
H M Nieman
Fred
F
Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
Meurs
Mieke M B
MMB
Department of Pediatrics, Atrium Medical Centre, Heerlen, The Netherlands.
van Waardenburg
Dick A
DA
Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
Ramsay
Graham
G
Department of Intensive Care, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
Donckerwolcke
Raymond A M G
RAMG
Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D010360:Patient Transfer / Q000379:methods*; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000628:therapy