title: Comparison of interhospital pediatric intensive care transport accompanied by a referring specialist or a specialist retrieval team.
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.
  
  
  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.
authors: Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. gvo@paed.azm.nl.
authors: Gijs D
authors: GD
authors: Vos
authors: Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors: Annemieke C
authors: AC
authors: Nissen
authors: Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors: Fred
authors: F
authors: H M Nieman
authors: Department of Pediatrics, Atrium Medical Centre, Heerlen, The Netherlands.
authors: Mieke M B
authors: MMB
authors: Meurs
authors: Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors: Dick A
authors: DA
authors: van Waardenburg
authors: Department of Intensive Care, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors: Graham
authors: G
authors: Ramsay
authors: Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors: Raymond A M G
authors: RAMG
authors: Donckerwolcke
mesh_terms: 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