title: Safety of transport and hyperbaric oxygen treatment in critically-ill patients from Padua hospitals into a centrally-located, stand-alone hyperbaric facility.
abstract: BACKGROUND
  Some patients admitted to the intensive care unit (ICU) might require repetitive hyperbaric oxygen treatment (HBOT) while receiving critical care. In such cases, the presence of a hyperbaric chamber located inside or near an ICU is preferable; however, this set-up is not always possible. In Padua, the "Associazione Tecnici IPerbarici" hyperbaric centre is a stand-alone facility outside of a hospital. Despite this, selected ICU patients receive HBOT at this facility.
  
  
  METHODS
  We retrospectively reviewed the medical records from 2003 to 2013 of 75 consecutive, critically-ill patients, 28 of whom were initially intubated and mechanically ventilated whilst undergoing HBOT. We evaluated the methods adopted in Padua to guarantee the safety and continuity of care during transfer for and during HBOT in this specially-equipped multiplace chamber.
  
  
  RESULTS
  The 75 patients collectively received 315 HBOT sessions, 192 of which were with the patients intubated and mechanically ventilated. The diagnoses ranged from necrotizing fasciitis to post-surgical sepsis and intracranial abscess. We obtained full recovery for 73 patients. Two deaths were recorded not in close time relation to HBOT.
  
  
  CONCLUSIONS
  With meticulous monitoring, efficient transport and well-trained personnel, the risks associated with transportation and HBOT can be acceptable for the referring physician.
authors.affiliation: Department of Biomedical Sciences, University of Padua, Padua, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Bosco
authors.affiliation: Associazione Tecnici IPerbarici (ATIP) Hyperbaric Medical Centre, Padua, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Garetto
authors.affiliation: Department of Biomedical Sciences, University of Padua, Padua, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rubini
authors.affiliation: Department of Biomedical Sciences, University of Padua, Padua, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Paoli
authors.affiliation: TeamHealth Anesthesia, Tampa General Hospital, Tampa, Florida, USA.
authors.forename: Prachiti
authors.initials: P
authors.lastname: Dalvi
authors.affiliation: Department of Surgery and TeamHealth Anesthesia, Tampa General Hospital, Tampa, Florida, USA.
authors.forename: Devanand
authors.initials: D
authors.lastname: Mangar
authors.affiliation: Department of Surgery and Anesthesiology, University of South Florida, Tampa, Florida ; TeamHealth Anesthesia, Tampa General Hospital, 1 Tampa General Hospital Circle, Suite A327, Tampa, Florida 33606, USA. ecampore@health.usf.edu.
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Camporesi
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000628:therapy; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods / Q000592:standards*; D016638:Critical Illness / Q000628:therapy*; D019115:Fasciitis, Necrotizing / Q000628:therapy; D005260:Female; D005738:Gas Gangrene / Q000628:therapy; D006268:Health Facilities; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data; D007558:Italy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D061214:Patient Safety / Q000592:standards*; D011183:Postoperative Complications / Q000628:therapy; D018805:Sepsis / Q000628:therapy; D014187:Transportation of Patients / Q000592:standards* / Q000706:statistics & numerical data
keywords: Hyperbaric oxygen therapy; clinical audit; fasciitis; infectious diseases; intensive care medicine; necrotizing; transport