OBJECTIVE: To compare the amount of variability in ventilation during intrahospital transport of intubated pediatric patients ventilated either manually or with a transport ventilator. DESIGN: Prospective, randomized study. SETTING: Tertiary, multidisciplinary, pediatric intensive care unit. PATIENTS: Forty-nine pediatric postoperative heart patients who required transport while still intubated. INTERVENTIONS: Patients were randomized to receive either manual ventilation during transport or ventilation by a portable mechanical ventilator. Baseline ventilatory and hemodynamic parameters were recorded before and during transport. Before and after arterial blood gases were also obtained. All other aspects of care were identical. MEASUREMENTS AND MAIN RESULTS: There was a statistically significant greater amount of variation in ventilation during transport with manual technique as opposed to the mechanical ventilator. A Student's t-test on pre- to post-blood gas differences showed a significantly lower PetCO2 (p = .02) in the manually ventilated patients when compared with the mechanically ventilated patients. Values for PCO2 were higher, but only marginally significant (p = .08). Repeated measures analysis of variance using these same pre- and post blood gas values confirmed the significant decrease in PetCO2 (p = .05). Minute to minute variation in PetCO2 during transport was greater and the mean values significantly lower in the manually ventilated group (p < .05). Hemodynamic data were remarkably stable when examined both before and after transport and on a minute to minute basis during transport. CONCLUSIONS: Manual ventilation during intrahospital transport results in greater fluctuation of ventilatory parameters from an established baseline than does use of a transport ventilator. No clinically significant changes in status occurred during the brief period of transport studied.
RCT Entities:
OBJECTIVE: To compare the amount of variability in ventilation during intrahospital transport of intubated pediatric patients ventilated either manually or with a transport ventilator. DESIGN: Prospective, randomized study. SETTING: Tertiary, multidisciplinary, pediatric intensive care unit. PATIENTS: Forty-nine pediatric postoperative heart patients who required transport while still intubated. INTERVENTIONS:Patients were randomized to receive either manual ventilation during transport or ventilation by a portable mechanical ventilator. Baseline ventilatory and hemodynamic parameters were recorded before and during transport. Before and after arterial blood gases were also obtained. All other aspects of care were identical. MEASUREMENTS AND MAIN RESULTS: There was a statistically significant greater amount of variation in ventilation during transport with manual technique as opposed to the mechanical ventilator. A Student's t-test on pre- to post-blood gas differences showed a significantly lower PetCO2 (p = .02) in the manually ventilated patients when compared with the mechanically ventilated patients. Values for PCO2 were higher, but only marginally significant (p = .08). Repeated measures analysis of variance using these same pre- and post blood gas values confirmed the significant decrease in PetCO2 (p = .05). Minute to minute variation in PetCO2 during transport was greater and the mean values significantly lower in the manually ventilated group (p < .05). Hemodynamic data were remarkably stable when examined both before and after transport and on a minute to minute basis during transport. CONCLUSIONS: Manual ventilation during intrahospital transport results in greater fluctuation of ventilatory parameters from an established baseline than does use of a transport ventilator. No clinically significant changes in status occurred during the brief period of transport studied.
Authors: Peter Winch; Sarah Khan; Aymen Naguib; Andrew R Yates; Julie Rice; N'diris Barry; Mark Galantowicz; Joseph D Tobias Journal: Int J Clin Exp Med Date: 2014-02-15
Authors: Gijs D Vos; Annemieke C Nissen; Fred H M Nieman; Mieke M B Meurs; Dick A van Waardenburg; Graham Ramsay; Raymond A M G Donckerwolcke Journal: Intensive Care Med Date: 2003-11-15 Impact factor: 17.440
Authors: Hyun Ju Min; Hyung-Jun Kim; Dong Seon Lee; Yun Young Choi; Miae Yoon; Dayoon Lee; Jun Yeun Cho; Jong Sun Park; Young-Jae Cho; Ho Il Yoon; Jae Ho Lee; Choon-Taek Lee; Yeon Joo Lee Journal: PLoS One Date: 2019-03-05 Impact factor: 3.240