Document Detail


Hyperventilation at referring hospitals is common before transport in intubated children with neurological diseases.
MedLine Citation:
PMID:  16215469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess if cardiopulmonary complications and abnormal carbon dioxide tension are more likely in intubated children with neurological diseases undergoing transport. METHODS: We reviewed the transport records of all ventilated children retrieved to a pediatric teaching hospital in the United States within a 12-month period. RESULTS: Twenty-seven children were transported by ground (n = 11), helicopter (n = 10), and fixed-wing aircraft (n = 6). Adjustments of ventilator settings were made in 17 (63%). There were no pneumothoraces, endotracheal tube complications, arrhythmias, or cardiopulmonary resuscitation en route. Twelve patients (44%) had a primary neurological condition. In the neurological category, the pretransport blood gases revealed 7 patients with hyperventilation (Pco2, 20-29 mm Hg), and the posttransport blood gases showed 4 patients with hyperventilation (Pco2, 15-28 mm Hg). In the nonneurological category, hyperventilation occurred only in one patient before and another after transport. No significant difference between the mode of transport, stabilization time, return time, and the occurrence of hypercapnia and hypocapnia was identified. Patients who had a neurological condition were more likely to be hyperventilated at the referring hospitals (P = 0.007). Additional maneuvers were considered necessary in 3 of the 6 neurological patients and 2 of the 5 nonneurological patients with DeltapH greater than +/-0.1, whereas the management of all but one patient with DeltapH less than +/-0.1 was considered appropriate (DeltapH defined as the difference between posttransport and pretransport pH values). CONCLUSION: There is no cardiopulmonary disaster in the various modes of pediatric transport. When compared with ground transport, there is no significant increase in the risk for cardiopulmonary complications or abnormal CO2 tension in air transport of intubated children. DeltapH, in conjunction with clinical data and PCO2 values, may be a simple index for evaluation of cardiopulmonary management during transport.
Authors:
Kam-lun Ellis Hon; Kam-Lun Ellis Hon; Holly Olsen; Balagangadhar Totapally; Ting-fan Leung
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  21     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-10     Completed Date:  2006-06-28     Revised Date:  2006-11-09    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  662-6     Citation Subset:  IM    
Affiliation:
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@cuhk.edu.hk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Carbon Dioxide / blood
Central Nervous System Diseases / complications*,  therapy
Child
Child, Preschool
Female
Humans
Hyperventilation / epidemiology,  etiology*
Infant
Intubation, Intratracheal*
Male
Patient Transfer
Retrospective Studies
Transportation of Patients*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comments/Corrections
Erratum In:
Pediatr Emerg Care. 2005 Nov;21(11):805
Note: Hon, Kam-Lun Ellis [corrected to Hon, Kam-lun Ellis]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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