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Wiener klinische Wochenschrift

, Volume 119, Issue 13–14, pp 412–416 | Cite as

Incidence of complications in intrahospital transport of critically ill patients – experience in an Austrian university hospital

  • Daniel Lahner
  • Ajsa Nikolic
  • Peter Marhofer
  • Herbert Koinig
  • Peter Germann
  • Christian Weinstabl
  • Claus G. Krenn
Original Article

Summary

BACKGROUND: During the past decade, considerable changes and advances have been made in intrahospital transport of critically ill patients. Despite the fact that intrahospital transport is nowadays regarded an extension of the intensive care continuum, it still poses a risk for the patient. MATERIALS AND METHODS: This prospective, observational study was designed to determine the occurrence rate of transport-related complications in the altered setting of intrahospital transports and to identify possible confounding sources of increased risk. In an eight-month period, adults and infants from anesthesiologic intensive care units were analyzed. RESULTS: A total of 226 patients underwent 452 intrahospital transports. The overall rate of critical incidents was low (4.2%) and no direct association between mortality and intrahospital transport was observed. In addition to the known risk factors of ventilatory support with positive end-expiratory pressure and requirement for catecholamine support, the necessity for intrahospital transport in the acute vs. elective situation was found to significantly increase the risk of complications. CONCLUSIONS: We conclude that advances in the management of intrahospital transport of critically ill patients have led to an overall decrease of complications. However, an undeniable risk remains, especially in relation to disease severity and the urgency of such transports.

Keywords

Intrahospital transport Complications Risk factors 

Inzidenz von Komplikationen beim innerklinischen Transport von kritisch kranken Patienten – Erfahrungen an einer österreichischen Universitätsklinik

Zusammenfassung

HINTERGRUND: Im letzten Jahrzehnt gab es gewaltige Fortschritte beim Transport von kritisch kranken Patienten im Krankenhaus. Obwohl der innerklinische Transport heutzutage als Kontinuum der Intensivbetreuung angesehen wird, stellt dieser immer noch ein spezielles Risiko für die Patienten dar. METHODIK: Diese prospektive Beobachtungsstudie hatte das Ziel, die Häufigkeit von transportassoziierten Komplikationen zu eruieren und zusätzliche Quellen für ein erhöhtes Komplikationsrisiko herauszufiltern. In einem Zeitraum von 8 Monaten wurden alle innerklinischen Transporte von Erwachsenen und Kindern von anästhesiologischen Intensivstationen beobachtet und analysiert. RESULTATE: Ingesamt wurden 452 Transporte an 226 Patienten durchgeführt. Die Gesamtrate an kritischen Zwischenfällen war niedrig (4,2%) und es konnte kein direkter Zusammenhang zwischen Mortalität und dem Transportprozess festgestellt werden. Neben bekannten Risikofaktoren wie Beatmung mit positiv endexspiratorischem Druck und Katecholaminbedarf des Patienten, stellte sich der akut indizierte Transport als signifikanter Risikofaktor heraus. SCHLUSSFOLGERUNG: Verbessertes Management solcher Transporte hat erheblich zur Risikominimierung beigetragen, obwohl nach wie vor besonders im Zusammenhang mit der Schwere der Erkrankung und der Dringlichkeit des Transports ein erhöhtes Restrisiko besteht.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Daniel Lahner
    • 1
  • Ajsa Nikolic
    • 1
  • Peter Marhofer
    • 1
  • Herbert Koinig
    • 1
  • Peter Germann
    • 1
  • Christian Weinstabl
    • 1
  • Claus G. Krenn
    • 1
  1. 1.Department of Anesthesiology and General Intensive CareMedical University of ViennaViennaAustria

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