Susan R Wilcox1, Mark S Saia2, Heather Waden2, Alissa Genthon3, Jonathan D Gates4, Michael N Cocchi5, Susan J McGahn6, Michael Frakes2, Suzanne K Wedel2, Jeremy B Richards7. 1. Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA. 2. Boston MedFlight, Bedford, MA. 3. Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA. 4. Division of Trauma and Acute Care Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, MA. 5. Department of Emergency Medicine and Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA. 6. Boston MedFlight, Bedford, MA. Electronic address: swilcox1@partners.org. 7. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
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. CONCLUSION: 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.
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. CONCLUSION: 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: Raghu R Seethala; Michael A Frakes; Michael N Cocchi; Jason E Cohen; James Dargin; Frank Friedman; Christian Grant; Adam Kaye; Susan R Wilcox Journal: Crit Care Explor Date: 2020-12-03
Authors: Gino La Rosa; Xabier de Aretxabala; Terry Martin; Julio Barreto; Victor Aguilera; Max Wanner; Pablo Gonzalez; Gonzalo Suarez; Viviana Leiva; Miguel Herve Journal: Air Med J Date: 2022-01-10