Point-of-care blood analyzer during the interhospital transport of critically ill children.
OBJECTIVE
To investigate the influence of point-of-care laboratory results (arterial blood gases, ionized calcium, potassium, sodium, glucose, hematocrit and hemoglobin) on therapeutic interventions during interhospital pediatric intensive care transport.


METHODS
Prospective observational study.


METHODS
Specialist pediatric intensive care retrieval team of a university hospital.


METHODS
Critically ill pediatric patients who were referred from a community hospital to a pediatric intensive care of a tertiary center. The retrieval team sampled arterial blood during the time of stabilization in the referring hospital and during transport. All results were recorded and for each result the physician of the specialist retrieval team wrote down the influence on the treatment (none, partly, only). The physician specified the kind of intervention.


RESULTS
Point-of-care blood analyses influenced the therapeutic management in 76.5% of all blood samples and in 86.2% of the referred patients. Of all interventions, 42.9% were based only on the laboratory results. The majority of interventions were adjustments of the mechanical ventilation. Point-of-care blood analyses reduced the delay in treatment of potentially life-threatening abnormalities of laboratory results (severe hypokalemia and low hematocrit).


CONCLUSIONS
During interhospital pediatric intensive care transport, point-of-care blood analyses frequently led to therapeutic interventions. Some abnormal blood results were potentially life threatening and could not have been discovered without point-of-care measurement. We therefore recommend the use of a point-of-care blood analyzer during interhospital intensive care transports, not only for blood gases but also for electrolytes, glucose and hematocrit.
Vos
Gijs
G
Department of Pediatrics, Division of Pediatric Intensive Care, University Hospital Maastricht, Maastricht, The Netherlands. gvo@paed.azm.nl
Engel
Monique
M
Ramsay
Graham
G
van Waardenburg
Dick
D
D001322:Autoanalysis; D001774:Blood Chemical Analysis / Q000295:instrumentation*; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods*; D003657:Decision Making; D006764:Hospitals, Community; D006801:Humans; D015278:Intensive Care Units, Pediatric; D019095:Point-of-Care Systems; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D014187:Transportation of Patients
D011933:Reagent Kits, Diagnostic