Improved Oxygenation After Transport in Patients With Hypoxemic Respiratory Failure

Abstract Objective The purpose of this study is to measure the rate and magnitude of changes in oxygenation that occur in patients with hypoxemic respiratory failure after transport by a critical care transport team. Methods We performed a retrospective review of 239 transports of patients with hypo...

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Bibliographic Details
Published in:Air medical journal 2015-11, Vol.34 (6), p.369-376
Main Authors: Wilcox, Susan R., MD, Saia, Mark S., BS, RRT, NRP, FP-C, Waden, Heather, RN, MSN, CCNS, CCRN, CFRN, CEN, EMT, Genthon, Alissa, MD, Gates, Jonathan D., MD, MBA, Cocchi, Michael N., MD, McGahn, Susan J., MSN, CCRN, CEN, EMT, Frakes, Michael, APRN, CCNS, CFRN, CCRN, EMTP, Wedel, Suzanne K., MD, Richards, Jeremy B., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Blood Gas Analysis
Critical Care
Disease Management
Emergency
Female
Health administration
Humans
Hypoxia - therapy
Internal Medicine
Male
Middle Aged
Oximetry
Partial Pressure
Respiratory Distress Syndrome, Adult - therapy
Respiratory Insufficiency - therapy
Retrospective Studies
Tertiary Care Centers
Transportation of Patients
Treatment Outcome
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Summary:Abstract Objective The purpose of this study is to measure the rate and magnitude of changes in oxygenation that occur in patients with hypoxemic respiratory failure after transport by a critical care transport team. Methods We performed a retrospective review of 239 transports of patients with hypoxemic respiratory failure requiring a fraction of inspired oxygen (Fio2 ) > 50% transported from October 2009 to December 2012 from referring hospitals to 3 tertiary care hospitals. We analyzed the change the ratio of the partial pressure of oxygen in the blood to FiO2 from the sending to the receiving hospital as well as the percentage saturation of oxygen (Spo2 ) before, after, and en route. Results The mean change in the Pao2 /Fio2 ratio from the sending to the receiving hospital was an increase of 27.62 (95% confidence interval [CI], 15.84-39.40; P = .0003). The mean change in Pao2 was an increase of 27.85 mm Hg (CI, 17.49-38.22; P < .0001). The mean Spo2 was not significantly changed at −0.12 (CI, – 1.69 to 1.45, P = .9). Despite improvement in the Pao2 /Fio2 ratio and a stable Spo2 on arrival, 28.1% of patients desaturated to Spo2 < 90% in transport. Conclusion In patients with hypoxemic respiratory failure, Pao2 /Fio2 and Pao2 increased after transport by a critical care transport team despite 28.1% of patients desaturating with hypoxemia in transit.
ISSN:1067-991X
1532-6497
DOI:10.1016/j.amj.2015.07.006