Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output
Abstract Background During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were transferred not only between hospitals by ambulance but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the physiological impact of helicopter...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-022-02177-5 |
| _version_ | 1818016651994464256 |
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| author | Cornelis Slagt Eduard Johannes Spoelder Marijn Cornelia Theresia Tacken Maartje Frijlink Sjoerd Servaas Guus Leijte Lucas Theodorus van Eijk Geert Jan van Geffen |
| author_facet | Cornelis Slagt Eduard Johannes Spoelder Marijn Cornelia Theresia Tacken Maartje Frijlink Sjoerd Servaas Guus Leijte Lucas Theodorus van Eijk Geert Jan van Geffen |
| author_sort | Cornelis Slagt |
| collection | DOAJ |
| description | Abstract Background During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were transferred not only between hospitals by ambulance but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the physiological impact of helicopter transport on critically ill patients and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated patients with severe COVID-19, with special focus on take-off, midflight, and landing. Methods All ventilated critically ill COVID-19 patients who were transported between April 2020 and June 2021 by the Dutch ‘Lifeliner 5’ HEMS team and who were fully monitored, including noninvasive cardiac output, were included in this study. Three 10-min timeframes (take-off, midflight and landing) were defined for analysis. Continuous data on the vital parameters heart rate, peripheral oxygen saturation, arterial blood pressure, end-tidal CO2 and noninvasive cardiac output using electrical cardiometry were collected and stored at 1-min intervals. Data were analyzed for differences over time within the timeframes using one-way analysis of variance. Significant differences were checked for clinical relevance. Results Ninety-eight patients were included in the analysis. During take-off, an increase was noticed in cardiac output (from 6.7 to 8.2 L min−1; P < 0.0001), which was determined by a decrease in systemic vascular resistance (from 1071 to 739 dyne·s·cm−5, P < 0.0001) accompanied by an increase in stroke volume (from 88.8 to 113.7 mL, P < 0.0001). Other parameters were unchanged during take-off and mid-flight. During landing, cardiac output and stroke volume slightly decreased (from 8.0 to 6.8 L min−1, P < 0.0001 and from 110.1 to 84.4 mL, P < 0.0001, respectively), and total systemic vascular resistance increased (P < 0.0001). Though statistically significant, the found changes were small and not clinically relevant to the medical status of the patients as judged by the attending physicians. Conclusions Interhospital helicopter transfer of ventilated intensive care patients with COVID-19 can be performed safely and does not result in clinically relevant changes in vital signs. |
| first_indexed | 2024-04-14T07:15:36Z |
| format | Article |
| id | doaj.art-26a7d3b9e87e41db8b872455459786d2 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-04-14T07:15:36Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-26a7d3b9e87e41db8b872455459786d22022-12-22T02:06:18ZengBMCRespiratory Research1465-993X2022-09-012311910.1186/s12931-022-02177-5Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac outputCornelis Slagt0Eduard Johannes Spoelder1Marijn Cornelia Theresia Tacken2Maartje Frijlink3Sjoerd Servaas4Guus Leijte5Lucas Theodorus van Eijk6Geert Jan van Geffen7Helicopter Emergency Medical Service Lifeliner 3 and 5Helicopter Emergency Medical Service Lifeliner 3 and 5Helicopter Emergency Medical Service Lifeliner 3 and 5Helicopter Emergency Medical Service Lifeliner 3 and 5Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical CentreDepartment of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical CentreDepartment of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical CentreHelicopter Emergency Medical Service Lifeliner 3 and 5Abstract Background During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were transferred not only between hospitals by ambulance but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the physiological impact of helicopter transport on critically ill patients and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated patients with severe COVID-19, with special focus on take-off, midflight, and landing. Methods All ventilated critically ill COVID-19 patients who were transported between April 2020 and June 2021 by the Dutch ‘Lifeliner 5’ HEMS team and who were fully monitored, including noninvasive cardiac output, were included in this study. Three 10-min timeframes (take-off, midflight and landing) were defined for analysis. Continuous data on the vital parameters heart rate, peripheral oxygen saturation, arterial blood pressure, end-tidal CO2 and noninvasive cardiac output using electrical cardiometry were collected and stored at 1-min intervals. Data were analyzed for differences over time within the timeframes using one-way analysis of variance. Significant differences were checked for clinical relevance. Results Ninety-eight patients were included in the analysis. During take-off, an increase was noticed in cardiac output (from 6.7 to 8.2 L min−1; P < 0.0001), which was determined by a decrease in systemic vascular resistance (from 1071 to 739 dyne·s·cm−5, P < 0.0001) accompanied by an increase in stroke volume (from 88.8 to 113.7 mL, P < 0.0001). Other parameters were unchanged during take-off and mid-flight. During landing, cardiac output and stroke volume slightly decreased (from 8.0 to 6.8 L min−1, P < 0.0001 and from 110.1 to 84.4 mL, P < 0.0001, respectively), and total systemic vascular resistance increased (P < 0.0001). Though statistically significant, the found changes were small and not clinically relevant to the medical status of the patients as judged by the attending physicians. Conclusions Interhospital helicopter transfer of ventilated intensive care patients with COVID-19 can be performed safely and does not result in clinically relevant changes in vital signs.https://doi.org/10.1186/s12931-022-02177-5Critical careCOVID-19Noninvasive hemodynamic monitoringElectrical cardiometryVital signsCardiac output. Helicopter Emergency Medical Service (HEMS) |
| spellingShingle | Cornelis Slagt Eduard Johannes Spoelder Marijn Cornelia Theresia Tacken Maartje Frijlink Sjoerd Servaas Guus Leijte Lucas Theodorus van Eijk Geert Jan van Geffen Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output Respiratory Research Critical care COVID-19 Noninvasive hemodynamic monitoring Electrical cardiometry Vital signs Cardiac output. Helicopter Emergency Medical Service (HEMS) |
| title | Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output |
| title_full | Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output |
| title_fullStr | Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output |
| title_full_unstemmed | Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output |
| title_short | Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output |
| title_sort | safety during interhospital helicopter transfer of ventilated covid 19 patients no clinical relevant changes in vital signs including non invasive cardiac output |
| topic | Critical care COVID-19 Noninvasive hemodynamic monitoring Electrical cardiometry Vital signs Cardiac output. Helicopter Emergency Medical Service (HEMS) |
| url | https://doi.org/10.1186/s12931-022-02177-5 |
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