Gijs D Vos1, Annemieke C Nissen2, Fred H M Nieman3, Mieke M B Meurs4, Dick A van Waardenburg5, Graham Ramsay6, Raymond A M G Donckerwolcke5. 1. Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. gvo@paed.azm.nl. 2. Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands. 3. Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. 4. Department of Pediatrics, Atrium Medical Centre, Heerlen, The Netherlands. 5. Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. 6. Department of Intensive Care, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
Abstract
OBJECTIVE: Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups. DESIGN AND SETTING: Prospective observational clinical study in pediatric intensive care units of Dutch university hospitals. PATIENTS: 249 pediatric patients requiring interhospital intensive care transport. METHODS: Data were collected on interhospital pediatric intensive care transports. We compared patient characteristics, interventions before and directly after transport, complications and equipment available during transport (137 accompanied by referring specialists, 112 by specialist retrieval teams). RESULTS: Interhospital transports accompanied by referring specialists had a longer average transport time (74.6 vs. 60.2 min), higher incidence of respiratory insufficiency (56.9% vs. 41.1%), and lower incidence of circulatory insufficiency (27.0% vs. 41.1%) than primary admission diagnoses. These transports had a lower percentage of ventilatory support (47.4% vs. 72.3%), higher need for acute interventions directly upon arrival on the pediatric ICU, and higher incidence of critical and serious complications. In 75% of the transfers accompanied by retrieval teams interventions before the transport were deemed to be necessary. During the transports accompanied by referring specialists the equipment and materials available proved rather limited. CONCLUSIONS: During pediatric intensive care transports accompanied by nontrained referring specialists there appears to be a higher incidence of complications, specialized equipment is more often not available, and more acute interventions are required upon arrival in the pediatric ICU.
OBJECTIVE: Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups. DESIGN AND SETTING: Prospective observational clinical study in pediatric intensive care units of Dutch university hospitals. PATIENTS: 249 pediatric patients requiring interhospital intensive care transport. METHODS: Data were collected on interhospital pediatric intensive care transports. We compared patient characteristics, interventions before and directly after transport, complications and equipment available during transport (137 accompanied by referring specialists, 112 by specialist retrieval teams). RESULTS: Interhospital transports accompanied by referring specialists had a longer average transport time (74.6 vs. 60.2 min), higher incidence of respiratory insufficiency (56.9% vs. 41.1%), and lower incidence of circulatory insufficiency (27.0% vs. 41.1%) than primary admission diagnoses. These transports had a lower percentage of ventilatory support (47.4% vs. 72.3%), higher need for acute interventions directly upon arrival on the pediatric ICU, and higher incidence of critical and serious complications. In 75% of the transfers accompanied by retrieval teams interventions before the transport were deemed to be necessary. During the transports accompanied by referring specialists the equipment and materials available proved rather limited. CONCLUSIONS: During pediatric intensive care transports accompanied by nontrained referring specialists there appears to be a higher incidence of complications, specialized equipment is more often not available, and more acute interventions are required upon arrival in the pediatric ICU.
Authors: S M Tibby; D Taylor; M Festa; S Hanna; M Hatherill; G Jones; P Habibi; A Durward; I A Murdoch Journal: Arch Dis Child Date: 2002-11 Impact factor: 3.791
Authors: Adrian Yu-Teik Goh; Mohd El-Amin Abdel-Latif; Lucy Chai-See Lum; Mohd Nazir Abu-Bakar Journal: Intensive Care Med Date: 2002-12-04 Impact factor: 17.440
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerome Pugin; Michael Pinsky; Peter Radermacher; Christian Richard; Robert Tasker; Benoit Vallet Journal: Intensive Care Med Date: 2005-02-18 Impact factor: 17.440
Authors: Jesus A Serra; Franco Díaz; Pablo Cruces; Cristobal Carvajal; Maria J Nuñez; A Donoso; J A Bravo-Serrano; M Carbonell; C Courtie; A Fernández; L Martínez-Arroyo; J Martínez; S Menta; Luis Pedrozo-Ortiz; A Wegner; Nicolas Monteverde-Fernández; Juan C Jaramillo-Bustamante; Roberto Jabornisky; Sebastián González-Dambrauskas; Sapna R Kudchadkar; Pablo Vásquez-Hoyos Journal: J Pediatr Intensive Care Date: 2021-05-20
Authors: Luregn J Schlapbach; Jonas Schaefer; Ann-Maree Brady; Sara Mayfield; Andreas Schibler Journal: Intensive Care Med Date: 2014-02-15 Impact factor: 17.440