Department of Medicine, Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University School of Medicine, New Orleans, LA, USA.
Department of Surgery, Section of Trauma/Critical Care Surgery, Louisiana State University School of Medicine, New Orleans, LA, USA.
J Intensive Care Med. 2019 Nov-Dec;34(11-12):1010-1016. doi: 10.1177/0885066617726754. Epub 2017 Aug 18.
Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU patients in a single day is associated with changes in vital signs, device removal, and worse clinical outcomes. We conducted a prospective, observational, cohort study of all critically ill adults admitted to a tertiary medical center's ICUs on the day of a planned hospital relocation and exposed to interhospital ICU relocation compared with unexposed critically ill adults. Changes in vital signs were evaluated by the before-and-after interhospital relocation measurement of vital signs, and clinical outcomes were collected for all patients. A total of 699 patients were admitted to the ICU during the observation period, 24 of whom were exposed to interhospital ICU relocation on a single day. The median interhospital transport duration was 28 minutes (interquartile range: 24-35) and 29% of patients were receiving invasive mechanical ventilation. Patients exposed to interhospital ICU relocation had no significant change in any vital sign measurement and no devices were unintentionally removed. Inhospital mortality was similar (8.3%) to patients not exposed to interhospital ICU relocation (9.2%, > .99). In the setting of adherence to an ICU relocation protocol, the interhospital ICU relocation of all critically ill adults during a single day is not associated with changes in vital signs, device removal, or worse clinical outcomes.
大量危重症患者在医院之间的转移有时是必要的，与转移相关的风险可能很高。在遵守医院间重症监护病房（ICU）转移协议的情况下，我们旨在确定在一天内将所有 ICU 患者转移到医院间是否与生命体征变化、设备移除和更差的临床结果有关。我们对计划医院搬迁当天入住三级医疗中心 ICU 的所有成年危重症患者进行了前瞻性、观察性、队列研究，并将其暴露于医院间 ICU 转移与未暴露于危重症患者进行了比较。生命体征的变化通过在医院间转移前后测量生命体征来评估，并且为所有患者收集了临床结果。在观察期间，共有 699 名患者入住 ICU，其中 24 名患者在一天内接受了医院间 ICU 转移。医院间转运的中位持续时间为 28 分钟（四分位间距：24-35），29%的患者接受了有创机械通气。接受医院间 ICU 转移的患者的任何生命体征测量值均无明显变化，也没有设备被意外移除。院内死亡率与未接受医院间 ICU 转移的患者相似（8.3%，>.99）。在遵守 ICU 转移协议的情况下，一天内将所有危重症成人转移到医院间不会导致生命体征变化、设备移除或更差的临床结果。
