Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, Switzerland.
Swiss Med Wkly. 2012 Apr 27;142:w13552. doi: 10.4414/smw.2012.13552. eCollection 2012.
Inter-hospital transfers are high-risk operations for critically ill patients dependent on intra-aortic balloon pump (IABP) support. Since September 2008, Swiss Air-Rescue (Rega) has offered such transfers by helicopter. The aim of the present study was to review the first 38 IABP transfers and to promulgate the currently used standard operating procedure (SOP).
All helicopter transfers of IABP-dependent patients by Swiss Air-Rescue (Rega) between September 2008 and October 2010 were retrospectively analysed. Adverse events (e.g., death), vital parameters and respiratory modus during takeover by the Rega crew and discharge at the receiving hospital, as well as patient demographics, aetiology of heart failure and outcome at the receiving hospital were assessed.
A total of 38 IABP transfers occurred, 35 of which were carried out to hospitals within Switzerland. No major adverse events were observed during flight. The mean patient age was 64 ± 11 (mean ± SD) years. The leading cause for IABP support was ischaemic heart failure (32 patients, 84%). The outcome of 35 patients was available: 30 were discharged home or to another institution, and 5 died at the receiving hospital.
Based on these findings, the helicopter transport, the equipment provided, the crew composition and the predefined process offer a safe concept for these complex transfers. The adherence to standard operating procedures is a precondition to achieve excellent quality of care, facilitating and accelerating the hand-over and comprehensive care of such high-risk patients.
对于依赖主动脉内球囊泵（IABP）支持的危重症患者，院内转运会是高风险操作。自 2008 年 9 月以来，瑞士空中救援（Rega）已提供直升机转院服务。本研究旨在回顾前 38 例 IABP 转院，并公布目前使用的标准作业程序（SOP）。
回顾分析 2008 年 9 月至 2010 年 10 月期间，瑞士空中救援（Rega）直升机转运依赖 IABP 的患者。评估 Rega 机组在接收医院接收和出院时的不良事件（如死亡）、生命体征和呼吸模式，以及患者人口统计学、心力衰竭病因和接收医院的预后。
共进行了 38 例 IABP 转院，其中 35 例在瑞士境内的医院进行。飞行过程中未发生重大不良事件。患者平均年龄为 64 ± 11 岁（均值 ± 标准差）。IABP 支持的主要病因是缺血性心力衰竭（32 例，84%）。35 例患者的预后情况：30 例出院或转至其他机构，5 例在接收医院死亡。
基于这些发现，直升机转运、提供的设备、机组人员构成和预定义流程为这些复杂的转运提供了安全的概念。遵守标准作业程序是实现卓越护理质量的前提，有助于和加速此类高危患者的交接和全面护理。
