Incidence of complications in intrahospital transport of critically ill patients--experience in an Austrian university hospital.
BACKGROUND
During the past decade, considerable changes and advances have been made in intrahospital transport of critically ill patients. Despite the fact that intrahospital transport is nowadays regarded an extension of the intensive care continuum, it still poses a risk for the patient.


METHODS
This prospective, observational study was designed to determine the occurrence rate of transport-related complications in the altered setting of intrahospital transports and to identify possible confounding sources of increased risk. In an eight-month period, adults and infants from anesthesiologic intensive care units were analyzed.


RESULTS
A total of 226 patients underwent 452 intrahospital transports. The overall rate of critical incidents was low (4.2%) and no direct association between mortality and intrahospital transport was observed. In addition to the known risk factors of ventilatory support with positive end-expiratory pressure and requirement for catecholamine support, the necessity for intrahospital transport in the acute vs. elective situation was found to significantly increase the risk of complications.


CONCLUSIONS
We conclude that advances in the management of intrahospital transport of critically ill patients have led to an overall decrease of complications. However, an undeniable risk remains, especially in relation to disease severity and the urgency of such transports.
Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria. daniel.lahner@meduniwien.ac.at
Daniel
D
Lahner
Ajsa
A
Nikolic
Peter
P
Marhofer
Herbert
H
Koinig
Peter
P
Germann
Christian
C
Weinstabl
Claus G
CG
Krenn
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D001513:Beds; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008020:Life Support Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012307:Risk Factors; D013647:Task Performance and Analysis; D014187:Transportation of Patients / Q000379:methods* / Q000706:statistics & numerical data