Parveez Mohd Qurram, Yaddanapudi Lakshmi Narayana, Saini Vikas, Kajal Kamal, Sharma Ankur
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Trauma and Emergency (Anaesthesiology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Turk J Emerg Med. 2020 Jul 18;20(3):135-141. doi: 10.4103/2452-2473.290067. eCollection 2020 Jul-Sep.
Intensive care unit (ICU) patients are at an increased risk of many catastrophic events during intrahospital transport (IHT) for various procedures. This study was planned to determine the incidence and types of adverse events occurring during the transport of critically ill patients in a tertiary care hospital.
This prospective observational study was conducted in the ICU of a tertiary care hospital for 8 months after ethical clearance from the institute ethics committee. All patients transported out of the ICU during the audit period for diagnostic or therapeutic procedures were included in the study. Vitals and several study parameters were recorded before, during, and after shifting patients to and from the ICU. Various critical events were noted during transport and classified into major and minor critical events based on the presence and absence of potential consequences that lead to a change of therapy during transport.
One hundred and sixty patients were studied for consecutive IHT to and from the ICU. The patients were transported for imaging studies (58.1%), minor surgery (31.8%), major surgery (2.5%), and other procedures (7.5%). A total of 248 critical events were observed in 104 IHTs (65%; 95% confidence interval [95% CI]: 57.4%-72.1%). Hence, an average of 2.38 critical events occurred per IHT. There were 31 major events among the 248 critical events (12.5%; 95% CI: 8.8%-17.1%).
Standard guidelines about the accompanying personnel and monitoring need to be followed during IHT. Conduct of minor surgical procedures in the ICU and better bedside diagnostic procedures may be considered for the future.
重症监护病房（ICU）患者在因各种程序进行院内转运（IHT）期间发生许多灾难性事件的风险增加。本研究旨在确定三级护理医院中危重症患者转运期间发生不良事件的发生率和类型。
本前瞻性观察性研究在一家三级护理医院的ICU进行，经机构伦理委员会伦理批准后为期8个月。研究纳入了审核期间所有因诊断或治疗程序转出ICU的患者。在患者转入和转出ICU之前、期间和之后记录生命体征和几个研究参数。在转运期间记录各种危急事件，并根据在转运期间是否存在导致治疗改变的潜在后果将其分为重大和轻微危急事件。
对160例患者进行了往返ICU的连续IHT研究。患者因影像学检查（58.1%）、小手术（31.8%）、大手术（2.5%）和其他程序（7.5%）而被转运。在104次IHT中观察到总共248次危急事件（65%；95%置信区间[95%CI]：57.4%-72.1%）。因此，每次IHT平均发生2.38次危急事件。在248次危急事件中有31次重大事件（12.5%；95%CI：8.8%-17.1%）。
在IHT期间需要遵循关于陪同人员和监测的标准指南。未来可考虑在ICU进行小手术以及采用更好的床边诊断程序。
