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Abstract Background This review of the current literature of the intra-hospital transport of critically ill patients addresses the type and incidence of adverse effects risk factors and risk assessment The review will explore the available information on efficiency and cost-effectiveness of transferring such patients for diagnostic or therapeutic interventions within the hospital Methods and guidelines to prevent or reduce potential hazards and complications are provided Methods A Medline search was performed using the terms critical illness transport of patients patient transfer critical care monitoring and intra-hospital transport All information concerning the intra-hospital transport of patients was considered Results Adverse effects may occur in up to 70 of transports They include a change in heart rate arterial hypotension and hypertension increased intracranial pressure arrhythmias cardiac arrest change in respiratory rate hypocapnia hypercapnia and significant hypoxaemia No transport-related deaths have been reported In up to one-third of cases mishaps during transport were equipment related A long-term deterioration of respiratory function was observed in 12 of cases Patient-related risk indicators were found to be a high Therapeutic Intervention Severity Score mechanical ventilation ventilation with positive end-expiratory pressure and high injury severity score patients age duration of transport and destination of transport Acute Physiology and Chronic Health Evaluation II score personnel accompanying the patient and other factors were not found to correlate with an increased rate of complications Transports for diagnostic procedures resulted in a change in patient management in 40-50 of cases indicating a good riskbenefit ratio Conclusions To prevent adverse effects of intra-hospital transportation guidelines concerning the organisation of transport personnel equipment and monitoring should be established In particular the presence of a critical care physician during transport proper equipment to monitor vital functions and to treat such disturbances immediately and close control of the patients ventilation are of major importance It appears useful to use specifically constructed carts including standard intensive care unit ventilators in a selected group of patients To further reduce the rate
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