Complications of Intrahospital Transport in Critically III Patients

Abstract

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.