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• W2056285435 abstract "Introduction. – Le transport intrahospitalier (TIH) d’un malade de réanimation ventilé mécaniquement, l’expose à un risque accru de complications. Objectifs. – Le but de ce travail était d’évaluer chez ces patients, l’incidence des complications survenant au cours des TIH et d’en analyser les causes et les conséquences. Patients et méthodes. – Tous les TIH de patients intubés et ventilés, hospitalisés dans les services de réanimation médicale et chirurgicale d’un CHU, ont été inclus de manière prospective pendant trois mois. Les complications étaient classées en deux catégories : celles liées au patient (désaturation, agitation, instabilité hémodynamique, extubation) ou au ventilateur (panne ou défaut du matériel). Résultats. – Au total, 123 TIH concernant 64 malades ont été analysés parmi lesquels 64 TIH réalisés pour procédure diagnostique (tomodensitométrie) et 59 pour procédure thérapeutique (bloc opératoire ou radiologie interventionnelle). Il est survenu au moins un problème patient au cours de 41 transports (33 %) (désaturation n= 11, agitation n= 21, troubles hémodynamiques n= 19, extubation n= 0). Dans deux cas, ces complications ont évolué vers un arrêt cardiaque. L’incidence des problèmes patients était plus élevée lors des TIH de patients sédatés (66 % p= 0,0001) et lors des TIH pour procédure diagnostique (p= 0,03). Un problème machine est survenu au cours de 26 transports (21 %), plus fréquemment avec les ventilateurs à turbine (p= 0,0056). Conclusion. – Cette étude confirme que le TIH de patients de réanimation ventilés mécaniquement est une procédure à haut risque de complications potentiellement sévères. Ceci souligne l’intérêt des procédures standardisées de prise en charge et d’une médicalisation de la surveillance tout au long du déplacement. Introduction. – Intrahospital transport (IHT) of mechanically ventilated critically ill patients is associated with an important risk of complications. Objectives. – The purpose of this study was to assess the incidence of complications occurring during the IHT and to analyse the causes and the consequences of such complications. Patients and methods. – All the IHT performed in mechanically ventilated patients, hospitalised in medical and surgical intensive care units of a university hospital were prospectively included during a three-month period. Complications were defined as follows: patient related problems (desaturation, restlessness, haemodynamic instability, extubation) and ventilator related problems (breakdown or defect of the material). Results. – 123 IHT concerning 64 patients were analysed, with 64 IHT were realised for diagnostic procedure (computed tomography) and 59 for therapeutic procedure (surgical procedure or interventional radiology). At least one patient related problem occurred during 41 IHT (33%) (desaturation n= 11, agitation n = 21, haemodynamic alterations n= 19, extubation n= 0). In two patients, these complications led to cardiac arrest. Patient related problems were observed more frequently in sedated patient (66 %, p= 0.0001) as well as during IHT for diagnostic procedure (p= 0.03). A ventilator problem occurred in 26 transports (21 %) and was more frequently reported when a turbine ventilator was used (p= 0.0056). Conclusion. – This study supports the fact that IHT of mechanically ventilated critically ill patients, is a high-risk procedure associated with potentially severe complications. This finding emphasises the need of standardised procedures and medical surveillance during IHT." @default.
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• W2056285435 date "2005-01-01" @default.
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• W2056285435 title "Complications durant le transport intrahospitalier de malades critiques de réanimation" @default.
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• W2056285435 doi "https://doi.org/10.1016/j.annfar.2004.10.026" @default.
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