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Objectives: Data on long-term survival in children after interhospital transport to a PICU are scarce. The main objective was to investigate short- and long-term outcome after acute interhospital transport to a PICU for different age and risk stratification groups. Secondary aims were to investigate whether neonatal patients would have higher mortality and be more resource demanding than older patients.
Design: Single-center, retrospective cohort study.
Setting: Specialist pediatric transport team and a tertiary PICU in Sweden.
Patients: Critically ill children 0-18 years old, acutely transported by a specialist pediatric transport team to a PICU in Sweden (January 1, 2008, to December 31, 2016).
Interventions: None.
Measurements And Main Results: A total of 401 acute transport events were included. Overall mortality was 15.7% with a median follow-up time of 3.4 years (range, 0-10.2 yr). Median predicted death rate was 4.9%. There was no mortality during transport. Cumulative mortality almost doubled within the first 6 months after PICU discharge, from 6.5% to 12.0%. Of late deaths, 66.7% occurred in the risk stratification group predicted death rate 0-10%, and 95% suffered from severe comorbidity. There were no deaths after PICU discharge in the neonatal group. Cumulative mortality in multiple transported patients was 36.4%.
Conclusions: This is the first report on long-term survival after acute pediatric interhospital transport. For the entire cohort, there was significant mortality after PICU discharge, especially in multiple transported patients. In contrast, survival in the subgroup of neonatal patients was high after PICU discharge.
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http://dx.doi.org/10.1097/PCC.0000000000002319 | DOI Listing |
Int J Artif Organs
December 2024
Department of cardiovascular surgery, TC Saglik Bakanligi Kosuyolu Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Istanbul, Turkey.
Background: The emergence of COVID-19 has amplified the importance of efficient patient transfer, leading to the idea of inter-hospital ECMO transport programs. However, there are limited studies on ECMO transfer protocols and experiences during COVID pandemic. This study aimed to evaluate the effectiveness our transport program and provide insights into establishing and maintaining ECMO programs.
View Article and Find Full Text PDFArtif Organs
November 2024
Critical Care Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Background: There is a lack of documented cases regarding complications during ECMO transfer in middle-income countries. Using portable ECMO devices facilitates patient transport but entails significantly higher costs, necessitating evidence of their practical utility. This study aims to describe complications during ECMO transfer in Argentina and to compare complication rates between the integrated portable ECMO and non-portable ECMO systems.
View Article and Find Full Text PDFAust J Rural Health
November 2024
Dubbo Base Hospital, Dubbo, New South Wales, Australia.
Objective: This study aims to investigate in patients over 65 with neck of femur (NOF) fractures in Rural Australia, does initial presentation to a peripheral hospital result in a delay to surgery?
Design: Retrospective cohort study.
Setting: Dubba Base Hospital, Trauma Hospital Rural Australia (Modified Monash Model (MMM) 3) and catchment area (MMM 3-7), NSW, Australia.
Participants: The study includes 350 patients over 65, presenting with closed, unilateral NOF fractures who underwent operative management at the operating centre, 203 from peripheral hospitals.
Wien Klin Wochenschr
December 2024
Intensive Care Unit 13i2, Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Extracorporeal membrane oxygenation (ECMO) initiation at a non-ECMO-capable facility by specialized mobile teams aims for a stabilization prior to center admission, internationally referred to as ECMO retrieval. It is a recommended strategy to avoid primary interhospital transfer of compromised patients with a high risk of life-threatening incidents and potentially death. Deploying the unique skill set of ECMO installation and transportation to an unfamiliar environment, however, adds a further degree of complexity to the demanding fields of both transporting the critically ill and ECMO management itself.
View Article and Find Full Text PDFJMIR Form Res
December 2024
Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States.
Background: In interfacility transport care, a critical challenge exists in accurately matching ambulance response levels to patients' needs, often hindered by limited access to essential patient data at the time of transport requests. Existing systems cannot integrate patient data from sending hospitals' electronic health records (EHRs) into the transfer request process, primarily due to privacy concerns, interoperability challenges, and the sensitive nature of EHR data. We introduce a distributed digital health platform, Interfacility Transport Care (ITC)-InfoChain, designed to solve this problem without compromising EHR security or data privacy.
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