SIDNEY S. BRAMAN, M.D.; STEVEN M. DUNN, M.D.; CAROL A. AMICO, B.A.; RICHARD P. MILLMAN, M.D.
To determine the frequency of hemodynamic and respiratory complications during movement within the hospital, we conducted a prospective study involving 36 critically ill, ventilator-dependent patients who needed procedures done outside the intensive care unit. During the first 20 transports, patients received ventilation through a manual resuscitation bag. Arterial blood gas measurements showed frequent changes from baseline with alterations in PCO2 ( > 10 torr) or pH ( > 0.05) occurring on 14 occasions. In a subsequent study, 16 patients received ventilation during transit with the aid of a portable mechanical ventilator. Although 6 patients showed changes in arterial blood gas values, mean changes in PCO2 and pH were significantly less than in the group that received manual ventilatory support (p < 0.01). Hemodynamic complications of hypotension and cardiac arrhythmia showed a significant correlation with disturbances in arterial blood gases (p < 0.05). Although limited by the lack of a control period, this study shows that the transport of critically ill patients may result in severe hemodynamic complications; it also suggests that these complications might be prevented by more careful monitoring of ventilation.
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BRAMAN SS, DUNN SM, AMICO CA, MILLMAN RP. Complications of Intrahospital Transport in Critically III Patients. Ann Intern Med. 1987;107:469–473. doi: 10.7326/0003-4819-107-4-469
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Published: Ann Intern Med. 1987;107(4):469-473.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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