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Báo cáo y học: "Endothelial Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Endothelial Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team. | Wiegersma et al. Critical Care 2011 15 R75 http ccforum.eom content 15 1 R75 KS CRITICAL CARE RESEARCH Open Access Quality of interhospital transport of the critically ill impact of a Mobile Intensive Care Unit with a specialized retrieval team 1 11 2 1 Janke S Wiegersma Joep M Droogh Jan G Zijlstra Janneke Fokkema Jack JM Ligtenberg Abstract Introduction In order to minimize the additional risk of interhospital transport of critically ill patients we started a mobile intensive care unit MICU with a specialized retrieval team reaching out from our university hospital-based intensive care unit to our adherence region in March 2009. To evaluate the effects of this implementation we performed a prospective audit comparing adverse events and patient stability during MICU transfers with our previous data on transfers performed by standard ambulance. Methods All transfers performed by MICU from March 2009 until December 2009 were included. Data on 14 vital variables were collected at the moment of departure arrival and 24 hours after admission. Variables before and after transfer were compared using the paired-sample T-test. Major deterioration was expressed as a variable beyond a predefined critical threshold and was analyzed using the McNemar test and the Wilcoxon Signed Ranks test. Results were compared to the data of our previous prospective study on interhospital transfer performed by ambulance. Results A total of 74 interhospital transfers of ICU patients over a 10-month period were evaluated. An increase of total number of variables beyond critical threshold at arrival indicating a worsening of condition was found in 38 percent of patients. Thirty-two percent exhibited a decrease of one or more variables beyond critical threshold and 30 showed no difference. There was no correlation between patient status at arrival and the duration of transfer or severity of disease. ICU mortality was 28 . Systolic blood pressure glucose and haemoglobin were significantly .