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Quality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.

BACKGROUNDThe acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of A... Full description

Journal Title: Annals of intensive care January 15, 2018, Vol.8(1), p.5
Main Author: Blecha, Sebastian
Other Authors: Dodoo-Schittko, Frank , Brandstetter, Susanne , Brandl, Magdalena , Dittmar, Michael , Graf, Bernhard M , Karagiannidis, Christian , Apfelbacher, Christian , Bein, Thomas , Blecha, Sebastian
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 2110-5820 ; DOI: 10.1186/s13613-018-0357-y
Link: http://search.proquest.com/docview/1989579137/?pq-origsite=primo
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title: Quality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.
format: Article
creator:
  • Blecha, Sebastian
  • Dodoo-Schittko, Frank
  • Brandstetter, Susanne
  • Brandl, Magdalena
  • Dittmar, Michael
  • Graf, Bernhard M
  • Karagiannidis, Christian
  • Apfelbacher, Christian
  • Bein, Thomas
  • Blecha, Sebastian
subjects:
  • Ards
  • Inter-Hospital Transfer
  • Quality of Care
ispartof: Annals of intensive care, January 15, 2018, Vol.8(1), p.5
description: BACKGROUNDThe acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. METHODSWe evaluated medical and organizational aspects of structural and procedural quality relating to IHT of patients with ARDS in a prospective nationwide ARDS study. The qualification of emergency staff, the organizational aspects and the occurrence of critical events during transport were analyzed. RESULTSOut of 1234 ARDS patients, 431 (34.9%) were transported, and 52 of these (12.1%) treated with extracorporeal membrane oxygenation. 63.1% of transferred patients were male, median age was 54 years, and 26.8% of patients were obese. All patients were mechanically ventilated during IHT. Pressure-controlled ventilation was the preferred mode (92.1%). Median duration to organize the IHT was 165 min. Median distance for IHT was 58 km, and median duration of IHT 60 min. Forty-two patient-related and 8 technology-related critical events (11.6%, 50 of 431 patients) were observed. When a critical event occurred, the PaO2/FiO2 ratio before transport was significant lower (68 vs. 80 mmHg, p = 0.017). 69.8% of physicians and 86.7% of paramedics confirmed all transfer qualifications according to requirements of the German faculty guidelines (DIVI). CONCLUSIONSThe transport of critically ill patients is associated with potential risks. In our study the rate of patient- and technology-related critical events was relatively low. A severe ARDS with a PaO2/FiO2 ratio < 70 mmHg seems to be a risk factor for the appearance of critical events during IHT. The majority of transport staff was well qualified. Time span for organization of IHT was relatively short. ECMO is an option to transport patients with a severe ARDS safely to specialized centers. Trial registration NCT02637011 (ClinicalTrials.gov, Registered 15 December 2015, retrospectively registered).
language: eng
source:
identifier: ISSN: 2110-5820 ; DOI: 10.1186/s13613-018-0357-y
fulltext: fulltext
issn:
  • 21105820
  • 2110-5820
url: Link


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titleQuality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.
creatorBlecha, Sebastian ; Dodoo-Schittko, Frank ; Brandstetter, Susanne ; Brandl, Magdalena ; Dittmar, Michael ; Graf, Bernhard M ; Karagiannidis, Christian ; Apfelbacher, Christian ; Bein, Thomas ; Blecha, Sebastian
contributorBickenbach, Johannes (correspondence author) ; Beeker, Thorben (record owner) ; Schürholz, Tobias ; Pezechk, Jessica ; Schloer, Jens ; Jaschinski, Ulrich ; Kreuzer, Ilse ; Kuckein, Oliver ; Weber-Carstens, Steffen ; Goldmann, Anton ; Angermair, Stefan ; Stoycheva, Krista ; Brederlau, Jörg ; Rieckehr, Nadja ; Schreiber, Gabriele ; Haennicke, Henriette ; Bach, Friedhelm ; Gummelt, Immo ; Haas, Silke ; Middeke, Catharina ; Vedder, Ina ; Klaproth, Marion ; Adamzik, Michael ; Karlik, Jan ; Martini, Stefan ; Robitzky, Luisa ; Putensen, Christian ; Muders, Thomas ; Lohmer, Ute ; Dembinski, Rolf ; Schäffner, Petra ; Wulff-Werner, Petra ; Landsiedel-Mechenbier, Elke ; Nickoleit-Bitzenberger, Daniela ; Silber, Ann-Kathrin ; Ragaller, Maximilian ; de Abreu, Marcello Gama ; Ulbricht, Alin ; Reisbach, Linda ; Zacharowski, Kai ; Meybohm, Patrick ; Pense, Karin ; Schwarzmann, Gerhard ; Reske, Johannes ; Hötzel, Alexander ; Kalbhenn, Johannes ; Metz, Christoph ; Haschka, Stefan ; Rauch, Stefan ; Quintel, Michael ; Harnisch, Lars-Olav ; Baumann, Sophie ; Kernchen, Andrea ; Friesecke, Sigrun ; Maletzki, Sebastian ; Kluge, Stefan ; Boenisch, Olaf ; Frings, Daniel ; Füllekrug, Birgit ; Jahn, Nils ; Kampe, Knut ; Ringeis, Grit ; Singer, Brigitte ; Wüstenberg, Robin ; Ahrens, Jörg ; Ruschulte, Heiner ; Gerdes, Andre ; Groß, Matthias ; Wiesner, Olaf ; Bayat-Graw, Aleksandra ; Brenner, Thorsten ; Schmitt, Felix ; Lipinski, Anna ; Henzler, Dietrich ; Eickmeyer, Klaas ; Krebs, Juliane ; Rodenberg, Iris ; Groesdonk, Heinrich ; Meiers, Kathrin ; Salm, Karen ; Volk, Thomas ; Fischer, Stefan ; Redwan, Basam ; Schmölz, Martin ; Schumann-Stoiber, Kathrin ; Eberl, Simone ; Lenz, Gunther ; Von Wernitz-Keibel, Thomas ; Zackel, Monika ; Bloos, Frank ; Bloos, Petra ; Braune, Anke ; Haucke, Anja ; Noack, Almut ; Kolanos, Steffi ; Kuhnsch, Heike ; Knuhr-Kohlberg, Karina ; Gehling, Markus ; Haller, Mathias ; Sturm, Anne ; Rossenbach, Jannik ; Schädler, Dirk ; D'Aria, Stefanie ; Karagiannidis, Christian ; Straßmann, Stephan ; Windisch, Wolfram ; Annecke, Thorsten ; Herff, Holger ; Schütz, Michael ; Bercker, Sven ; Reising, Hannah ; Dathe, Mandy ; Schlegel, Christian ; Lichy, Katrin ; Zink, Wolfgang ; Kötteritzsch, Jana ; Bodenstein, Marc ; Mauff, Susanne ; Straub, Peter ; Strang, Christof ; Prätsch, Florian ; Hachenberg, Thomas ; Kirschning, Thomas ; Friedrich, Thomas ; Mangold, Dennis ; Rolfes, Caroline ; Koch, Tilo ; Haake, Hendrik ; Offermanns, Katrin ; Friederich, Patrick ; Bingold, Florian ; Irlbeck, Michael ; Zwissler, Bernhard ; Kaufmann, Ines ; Bogdanski, Ralph ; Kapfer, Barbara ; Heim, Markus ; Edenharter, Günther ; Ellger, Björn ; Bause, Daniela ; Gerresheim, Götz ; Muschner, Dorothea ; Christ, Michael ; Geise, Arnim ; Beiderlinden, Martin ; Heuter, Thorsten ; Wipfel, Alexander ; Kargl, Werner ; Harth, Marion ; Englmeier, Christian ; Bein, Thomas ; Blecha, Sebastian ; Thomann-Hackner, Kathrin ; Zeder, Marius ; Stephan, Markus ; Glaser, Martin ; Häberle, Helene ; Bracht, Hendrik ; Heer, Christian ; Mast, Theresa ; Kredel, Markus ; Müllenbach, Ralf ; Müllenbach, Ralf ; Müllenbach, Ralf
ispartofAnnals of intensive care, January 15, 2018, Vol.8(1), p.5
identifierISSN: 2110-5820 ; DOI: 10.1186/s13613-018-0357-y
subjectArds ; Inter-Hospital Transfer ; Quality of Care
descriptionBACKGROUNDThe acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. METHODSWe evaluated medical and organizational aspects of structural and procedural quality relating to IHT of patients with ARDS in a prospective nationwide ARDS study. The qualification of emergency staff, the organizational aspects and the occurrence of critical events during transport were analyzed. RESULTSOut of 1234 ARDS patients, 431 (34.9%) were transported, and 52 of these (12.1%) treated with extracorporeal membrane oxygenation. 63.1% of transferred patients were male, median age was 54 years, and 26.8% of patients were obese. All patients were mechanically ventilated during IHT. Pressure-controlled ventilation was the preferred mode (92.1%). Median duration to organize the IHT was 165 min. Median distance for IHT was 58 km, and median duration of IHT 60 min. Forty-two patient-related and 8 technology-related critical events (11.6%, 50 of 431 patients) were observed. When a critical event occurred, the PaO2/FiO2 ratio before transport was significant lower (68 vs. 80 mmHg, p = 0.017). 69.8% of physicians and 86.7% of paramedics confirmed all transfer qualifications according to requirements of the German faculty guidelines (DIVI). CONCLUSIONSThe transport of critically ill patients is associated with potential risks. In our study the rate of patient- and technology-related critical events was relatively low. A severe ARDS with a PaO2/FiO2 ratio < 70 mmHg seems to be a risk factor for the appearance of critical events during IHT. The majority of transport staff was well qualified. Time span for organization of IHT was relatively short. ECMO is an option to transport patients with a severe ARDS safely to specialized centers. Trial registration NCT02637011 (ClinicalTrials.gov, Registered 15 December 2015, retrospectively registered).
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1Dodoo-Schittko, Frank
2Brandstetter, Susanne
3Brandl, Magdalena
4Dittmar, Michael
5Graf, Bernhard M
6Karagiannidis, Christian
7Apfelbacher, Christian
8Bein, Thomas
titleQuality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.
descriptionBACKGROUNDThe acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. METHODSWe evaluated medical and organizational aspects of structural and procedural quality relating to IHT of patients with ARDS in a prospective nationwide ARDS study. The qualification of emergency staff, the organizational aspects and the occurrence of critical events during transport were analyzed. RESULTSOut of 1234 ARDS patients, 431 (34.9%) were transported, and 52 of these (12.1%) treated with extracorporeal membrane oxygenation. 63.1% of transferred patients were male, median age was 54 years, and 26.8% of patients were obese. All patients were mechanically ventilated during IHT. Pressure-controlled ventilation was the preferred mode (92.1%). Median duration to organize the IHT was 165 min. Median distance for IHT was 58 km, and median duration of IHT 60 min. Forty-two patient-related and 8 technology-related critical events (11.6%, 50 of 431 patients) were observed. When a critical event occurred, the PaO2/FiO2 ratio before transport was significant lower (68 vs. 80 mmHg, p = 0.017). 69.8% of physicians and 86.7% of paramedics confirmed all transfer qualifications according to requirements of the German faculty guidelines (DIVI). CONCLUSIONSThe transport of critically ill patients is associated with potential risks. In our study the rate of patient- and technology-related critical events was relatively low. A severe ARDS with a PaO2/FiO2 ratio < 70 mmHg seems to be a risk factor for the appearance of critical events during IHT. The majority of transport staff was well qualified. Time span for organization of IHT was relatively short. ECMO is an option to transport patients with a severe ARDS safely to specialized centers. Trial registration NCT02637011 (ClinicalTrials.gov, Registered 15 December 2015, retrospectively registered).
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3Pezechk, Jessica
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5Jaschinski, Ulrich
6Kreuzer, Ilse
7Kuckein, Oliver
8Weber-Carstens, Steffen
9Goldmann, Anton
10Angermair, Stefan
11Stoycheva, Krista
12Brederlau, Jörg
13Rieckehr, Nadja
14Schreiber, Gabriele
15Haennicke, Henriette
16Bach, Friedhelm
17Gummelt, Immo
18Haas, Silke
19Middeke, Catharina
20Vedder, Ina
21Klaproth, Marion
22Adamzik, Michael
23Karlik, Jan
24Martini, Stefan
25Robitzky, Luisa
26Putensen, Christian
27Muders, Thomas
28Lohmer, Ute
29Dembinski, Rolf
30Schäffner, Petra
31Wulff-Werner, Petra
32Landsiedel-Mechenbier, Elke
33Nickoleit-Bitzenberger, Daniela
34Silber, Ann-Kathrin
35Ragaller, Maximilian
36de Abreu, Marcello Gama
37Ulbricht, Alin
38Reisbach, Linda
39Zacharowski, Kai
40Meybohm, Patrick
41Pense, Karin
42Schwarzmann, Gerhard
43Reske, Johannes
44Hötzel, Alexander
45Kalbhenn, Johannes
46Metz, Christoph
47Haschka, Stefan
48Rauch, Stefan
49Quintel, Michael
50Harnisch, Lars-Olav
51Baumann, Sophie
52Kernchen, Andrea
53Friesecke, Sigrun
54Maletzki, Sebastian
55Kluge, Stefan
56Boenisch, Olaf
57Frings, Daniel
58Füllekrug, Birgit
59Jahn, Nils
60Kampe, Knut
61Ringeis, Grit
62Singer, Brigitte
63Wüstenberg, Robin
64Ahrens, Jörg
65Ruschulte, Heiner
66Gerdes, Andre
67Groß, Matthias
68Wiesner, Olaf
69Bayat-Graw, Aleksandra
70Brenner, Thorsten
71Schmitt, Felix
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73Henzler, Dietrich
74Eickmeyer, Klaas
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76Rodenberg, Iris
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78Meiers, Kathrin
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80Volk, Thomas
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87Von Wernitz-Keibel, Thomas
88Zackel, Monika
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91Braune, Anke
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93Noack, Almut
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97Gehling, Markus
98Haller, Mathias
99Sturm, Anne
100...
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titleQuality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.
authorBlecha, Sebastian ; Dodoo-Schittko, Frank ; Brandstetter, Susanne ; Brandl, Magdalena ; Dittmar, Michael ; Graf, Bernhard M ; Karagiannidis, Christian ; Apfelbacher, Christian ; Bein, Thomas ; Blecha, Sebastian
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0Blecha, Sebastian
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8Bein, Thomas
9Bickenbach, Johannes
10Beeker, Thorben
11Schürholz, Tobias
12Pezechk, Jessica
13Schloer, Jens
14Jaschinski, Ulrich
15Kreuzer, Ilse
16Kuckein, Oliver
17Weber-Carstens, Steffen
18Goldmann, Anton
19Angermair, Stefan
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21Brederlau, Jörg
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23Schreiber, Gabriele
24Haennicke, Henriette
25Bach, Friedhelm
26Gummelt, Immo
27Haas, Silke
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29Vedder, Ina
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36Muders, Thomas
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38Dembinski, Rolf
39Schäffner, Petra
40Wulff-Werner, Petra
41Landsiedel-Mechenbier, Elke
42Nickoleit-Bitzenberger, Daniela
43Silber, Ann-Kathrin
44Ragaller, Maximilian
45de Abreu, Marcello Gama
46Ulbricht, Alin
47Reisbach, Linda
48Zacharowski, Kai
49Meybohm, Patrick
50Pense, Karin
51Schwarzmann, Gerhard
52Reske, Johannes
53Hötzel, Alexander
54Kalbhenn, Johannes
55Metz, Christoph
56Haschka, Stefan
57Rauch, Stefan
58Quintel, Michael
59Harnisch, Lars-Olav
60Baumann, Sophie
61Kernchen, Andrea
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63Maletzki, Sebastian
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96Knuhr-Kohlberg, Karina
97Gehling, Markus
98Haller, Mathias
99Sturm, Anne
100...
atitleQuality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.
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abstractBACKGROUNDThe acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. METHODSWe evaluated medical and organizational aspects of structural and procedural quality relating to IHT of patients with ARDS in a prospective nationwide ARDS study. The qualification of emergency staff, the organizational aspects and the occurrence of critical events during transport were analyzed. RESULTSOut of 1234 ARDS patients, 431 (34.9%) were transported, and 52 of these (12.1%) treated with extracorporeal membrane oxygenation. 63.1% of transferred patients were male, median age was 54 years, and 26.8% of patients were obese. All patients were mechanically ventilated during IHT. Pressure-controlled ventilation was the preferred mode (92.1%). Median duration to organize the IHT was 165 min. Median distance for IHT was 58 km, and median duration of IHT 60 min. Forty-two patient-related and 8 technology-related critical events (11.6%, 50 of 431 patients) were observed. When a critical event occurred, the PaO2/FiO2 ratio before transport was significant lower (68 vs. 80 mmHg, p = 0.017). 69.8% of physicians and 86.7% of paramedics confirmed all transfer qualifications according to requirements of the German faculty guidelines (DIVI). CONCLUSIONSThe transport of critically ill patients is associated with potential risks. In our study the rate of patient- and technology-related critical events was relatively low. A severe ARDS with a PaO2/FiO2 ratio < 70 mmHg seems to be a risk factor for the appearance of critical events during IHT. The majority of transport staff was well qualified. Time span for organization of IHT was relatively short. ECMO is an option to transport patients with a severe ARDS safely to specialized centers. Trial registration NCT02637011 (ClinicalTrials.gov, Registered 15 December 2015, retrospectively registered).
doi10.1186/s13613-018-0357-y
urlhttp://search.proquest.com/docview/1989579137/
orcidid0000-0002-0634-7588
date2018-01-15