Safe Intrahospital Transport of Critically Ill Ventilator-dependent Patients.

Weg JG, Haas CF Chest 1989 Vol 96 Pages 631-635

In this study, twenty mechanically ventilated critically ill patients were manually ventilated with a Puritan-Bennett PMR-2 resuscitation bag by a respiratory therapist during intrahospital transport. Mean transport time was 14.9 minutes/patient (range 5-40 minutes). No hemodynamic abnormalities resulted during transport. Arterial blood gases did not vary to any clinically significant degree except in two patients: One had a reduced PaO2 and increased PaCO2 associated with an accidental oxygen disconnection and clamped chest tube; another patient had an increased pH of 0.13 units with a 9 mmHg fall in PaCO2. The authors conclude than manual ventilation during intrahospital transport is safe provided the person performing manual ventilation knows the inspired oxygen fraction (FIO2) and minute ventilation required before transport, and is trained to approximate them. There is no data available concerning very high minute ventilation or high FIO2 requirements. In these patients, portable transport ventilators, expired volume monitors, end-tidal CO2 monitors, transcutaneous CO2, O2 monitors, and/or oximeters may be of value.