Hypoxaemia on arrival in a multidisciplinary intensive care unit

Area of Science:

• Critical Care Medicine
• Patient Transport Safety
• Respiratory Physiology

Background:

• Patient transport is associated with serious complications, including hypoxaemia.
• Hypoxaemia during transport can lead to significant morbidity and mortality.
• This adverse event is potentially preventable with appropriate interventions.

Purpose of the Study:

• To determine the incidence of hypoxaemia upon ICU admission.
• To identify risk factors associated with hypoxaemia during patient transport.
• To inform strategies for preventing transport-related hypoxaemia.

Main Methods:

• Retrospective observational study design.
• Data collected at a tertiary multidisciplinary intensive care unit in South Africa.
• Analysis of patient admissions from May 2013 to February 2014.

Main Results:

• Hypoxaemia was observed in 15.5% of sampled ICU admissions.
• Univariate analysis identified lack of SpO2 monitoring, intern-led transfers, and internal medicine origin as risk factors.
• Neuromuscular blockers and theatre transfers were protective.
• Lack of SpO2 monitoring was the sole independent predictor of hypoxaemia (OR 6.1, p=0.02).

Conclusions:

• Hypoxaemia is a common occurrence upon ICU admission.
• Simple interventions, particularly adequate transport monitoring, can prevent hypoxaemia.
• Implementing standardized monitoring protocols can improve patient safety during transport.