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危重症 COVID-19 患者的转运。

Critical Care Transport of Patients With COVID-19.

机构信息

485798Boston MedFlight, Boston, MA, USA.

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA.

出版信息

J Intensive Care Med. 2021 Jun;36(6):704-710. doi: 10.1177/08850666211001797. Epub 2021 Mar 22.

Abstract

PURPOSE

Critical care transport is associated with a high rate of adverse events, and the risks and outcomes of transporting critically ill patients during the COVID-19 pandemic have not been previously described.

MATERIALS AND METHODS

We performed a retrospective review of transports of subjects with suspected or confirmed COVID-19 from sending hospitals to tertiary care hospitals in Boston. Follow-up data were obtained for patients transported between March 1st and April 20th, 2020.

RESULTS

Of 254 charts identified, 250 patients were transported. Nine patients (3.5%) had cardiac arrest prior to transport. Twenty-nine (11.6%) had hypotension, 22 (8.8%) had a critical desaturation, and 4 (1.6%) had both en route. Hospital follow-up data were available for 189 patients. Of those intubated during their hospitalization, 44 (25.0%) had died, 59 (33.5%) had been extubated, and 13 (17.6%) had been discharged alive. For the subgroup with prior cardiac arrest, follow-up data available for 6. Of these 6, 2 died and 4 (66.7%) have been discharged alive.

CONCLUSIONS

Few patients with COVID-19 had an adverse event in transport. The in-hospital mortality rate was 25%, with a 33.5% extubation rate. Patients resuscitated from cardiac arrest prior to transport had a 66.7% discharge rate among those transported to consortium hospitals.

摘要

目的

重症监护转运与不良事件的发生率较高相关,在 COVID-19 大流行期间转运危重症患者的风险和结果以前尚未描述过。

材料和方法

我们对从发送医院到波士顿三级护理医院转运的疑似或确诊 COVID-19 患者进行了回顾性研究。对 2020 年 3 月 1 日至 4 月 20 日期间转运的患者进行了随访。

结果

在确定的 254 份图表中,有 250 名患者接受了转运。在转运前有 9 名患者(3.5%)发生了心脏骤停。29 名患者(11.6%)出现低血压,22 名患者(8.8%)出现严重的低氧血症,4 名患者(1.6%)在转运途中出现上述两种情况。有 189 名患者的医院随访数据可用。在住院期间接受插管的患者中,44 名(25.0%)死亡,59 名(33.5%)拔管,13 名(17.6%)存活出院。对于先前发生心脏骤停的亚组,有 6 名患者的随访数据可用。在这 6 名患者中,有 2 人死亡,4 人(66.7%)存活出院。

结论

COVID-19 患者在转运过程中很少发生不良事件。院内死亡率为 25%,拔管率为 33.5%。在转运至联盟医院的患者中,从心脏骤停中复苏的患者的出院率为 66.7%。

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