title: Improved Oxygenation After Transport in Patients With Hypoxemic Respiratory Failure.
abstract: OBJECTIVE
  The purpose of this study is to measure the rate and magnitude of changes in oxygenation that occur in patients with hypoxemic respiratory failure after transport by a critical care transport team.
  
  
  METHODS
  We performed a retrospective review of 239 transports of patients with hypoxemic respiratory failure requiring a fraction of inspired oxygen (Fio2) > 50% transported from October 2009 to December 2012 from referring hospitals to 3 tertiary care hospitals. We analyzed the change the ratio of the partial pressure of oxygen in the blood to FiO2 from the sending to the receiving hospital as well as the percentage saturation of oxygen (Spo2) before, after, and en route.
  
  
  RESULTS
  The mean change in the Pao2/Fio2 ratio from the sending to the receiving hospital was an increase of 27.62 (95% confidence interval [CI], 15.84-39.40; P = .0003). The mean change in Pao2 was an increase of 27.85 mm Hg (CI, 17.49-38.22; P < .0001). The mean Spo2 was not significantly changed at -0.12 (CI, - 1.69 to 1.45, P = .9). Despite improvement in the Pao2/Fio2 ratio and a stable Spo2 on arrival, 28.1% of patients desaturated to Spo2 < 90% in transport.
  
  
  CONCLUSIONS
  In patients with hypoxemic respiratory failure, Pao2/Fio2 and Pao2 increased after transport by a critical care transport team despite 28.1% of patients desaturating with hypoxemia in transit.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Wilcox
authors.affiliation: Boston MedFlight, Bedford, MA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Saia
authors.affiliation: Boston MedFlight, Bedford, MA.
authors.forename: Heather
authors.initials: H
authors.lastname: Waden
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Alissa
authors.initials: A
authors.lastname: Genthon
authors.affiliation: Division of Trauma and Acute Care Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, MA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Gates
authors.affiliation: Department of Emergency Medicine and Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cocchi
authors.affiliation: Boston MedFlight, Bedford, MA. Electronic address: swilcox1@partners.org.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: McGahn
authors.affiliation: Boston MedFlight, Bedford, MA.
authors.forename: Michael
authors.initials: M
authors.lastname: Frakes
authors.affiliation: Boston MedFlight, Bedford, MA.
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Wedel
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Richards
mesh_terms: D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D003422:Critical Care; D019468:Disease Management; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010313:Partial Pressure; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014187:Transportation of Patients; D016896:Treatment Outcome