Children's Acute Transport Service (CATS), London, United Kingdom.
Pediatr Crit Care Med. 2010 Jul;11(4):451-6. doi: 10.1097/PCC.0b013e3181e30ce7.
To examine the effects of patient- and transport-related factors on the time spent at the referring hospital by an intensive care retrieval team to stabilize critically ill children and to study the relationship between stabilization time and patient outcome.
: Analysis of prospectively collected data during pediatric intensive care transport.
A dedicated regional pediatric intensive care retrieval service performing interhospital transports in England.
Critically ill children transported to intensive care units over a 2-yr period between April 1, 2006 and March 31, 2008.
None.
Factors related to the patient (age group, diagnostic category, and severity of illness) and transport (time of referral, team response time, and number of major and minor interventions performed) were analyzed for their effect on stabilization time in univariate and multivariate analyses. The relationship between stabilization time and patient outcome in the first 24 hrs post intensive care unit admission was also studied. Patient acuity was high in the transported population (84% invasively ventilated; 28% on vasoactive agents). Predicted mortality risk (Pediatric Index of Mortality 2 score), diagnostic category, team response time, and number of major interventions performed had an independent effect on stabilization time, whereas the length of stabilization itself did not influence early mortality on the intensive care unit. Each minor intervention prolonged the stabilization time by an average of 10 mins.
Stabilization time during intensive care transport is influenced by a number of patient- and transport-related factors, and cannot be used in isolation as an indicator of team efficiency. Time spent undertaking intensive care interventions early in the course of patient illness at the referring hospital does not worsen patient outcome, suggesting that the "scoop and run" model can be safely abandoned in interhospital transport.
研究患者和转运相关因素对重症儿童急救转运团队在转诊医院停留时间的影响，并研究稳定化时间与患者预后之间的关系。
对儿科重症监护转运期间前瞻性收集的数据进行分析。
在英格兰，一家专门的区域性儿科重症监护转运服务机构，负责进行医院间转运。
2006 年 4 月 1 日至 2008 年 3 月 31 日期间，2 年内转运至重症监护病房的危重病儿。
无。
在单变量和多变量分析中，分析了与患者（年龄组、诊断类别和疾病严重程度）和转运（转诊时间、团队响应时间以及进行的主要和次要干预的次数）相关的因素对稳定化时间的影响。还研究了稳定化时间与重症监护病房入院后 24 小时内患者预后之间的关系。转运人群的患者病情严重（84%有创通气；28%使用血管活性药物）。预测死亡率风险（儿科死亡率 2 评分）、诊断类别、团队响应时间和主要干预次数对稳定化时间有独立影响，而稳定化本身的时间长短并不影响重症监护病房的早期死亡率。每次次要干预平均延长稳定化时间 10 分钟。
重症监护转运过程中的稳定化时间受多种患者和转运相关因素的影响，不能孤立地作为团队效率的指标。在转诊医院对患者疾病早期进行重症监护干预所花费的时间不会使患者预后恶化，这表明在医院间转运中可以安全地放弃“ scooping and run”模式。
