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Patient outcomes following transfer between intensive care units during the COVID-19 pandemic.
Huq, F; Manners, E; O'Callaghan, D; Thakuria, L; Weaver, C; Waheed, U; Stümpfle, R; Brett, S J; Patel, P; Soni, S.
  • Huq F; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Manners E; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • O'Callaghan D; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Thakuria L; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Weaver C; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Waheed U; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Stümpfle R; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Brett SJ; Division of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK.
  • Patel P; Department of Critical Care, Imperial College Healthcare NHS Trust, London, UK.
  • Soni S; Department of Surgery and Cancer, Imperial College London, London, UK.
Anaesthesia ; 77(4): 398-404, 2022 04.
Article in English | MEDLINE | ID: covidwho-1714114
ABSTRACT
Transferring critically ill patients between intensive care units (ICU) is often required in the UK, particularly during the COVID-19 pandemic. However, there is a paucity of data examining clinical outcomes following transfer of patients with COVID-19 and whether this strategy affects their acute physiology or outcome. We investigated all transfers of critically ill patients with COVID-19 between three different hospital ICUs, between March 2020 and March 2021. We focused on inter-hospital ICU transfers (those patients transferred between ICUs from different hospitals) and compared this cohort with intra-hospital ICU transfers (patients moved between different ICUs within the same hospital). A total of 507 transfers were assessed, of which 137 met the inclusion criteria. Forty-five patients underwent inter-hospital transfers compared with 92 intra-hospital transfers. There was no significant change in median compliance 6 h pre-transfer, immediately post-transfer and 24 h post-transfer in patients who underwent either intra-hospital or inter-hospital transfers. For inter-hospital transfers, there was an initial drop in median PaO2 /FI O2 ratio from median (IQR [range]) 25.1 (17.8-33.7 [12.1-78.0]) kPa 6 h pre-transfer to 19.5 (14.6-28.9 [9.8-52.0]) kPa immediately post-transfer (p < 0.05). However, this had resolved at 24 h post-transfer 25.4 (16.2-32.9 [9.4-51.9]) kPa. For intra-hospital transfers, there was no significant change in PaO2 /FI O2 ratio. We also found no meaningful difference in pH; PaCO2 ;, base excess; bicarbonate; or norepinephrine requirements. Our data demonstrate that patients with COVID-19 undergoing mechanical ventilation of the lungs may have short-term physiological deterioration when transferred between nearby hospitals but this resolves within 24 h. This finding is relevant to the UK critical care strategy in the face of unprecedented demand during the COVID-19 pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Anaesthesia Year: 2022 Document Type: Article Affiliation country: Anae.15680

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Anaesthesia Year: 2022 Document Type: Article Affiliation country: Anae.15680