INFLUENCE OF THE BLOOD GAS COMPOSITION AND MECHANICAL VENTILATION PARAMETERS OF THE MEDICAL EVACUATION PROGNOSIS OF CRITICALLY ILL PATIENTS

The clinical estimation of the state of patient is one of the basic components of the checking of the state of patient, but more precise and more objective indices today become necessary. The arterial blood gases analysis helps to select the optimum regime of mechanical ventilation. The medical evacuation of the critically ill patients frequently requires the correction of the parameters of respiratory support. The conducted investigations showed that the prognostics of unfavorable outcome within the first three days from the moment of the medical evacuation are hypercapnia, which exists during the process of evacuation in spite of the correction of the parameters of mechanical ventilation, reduction in the saturation of the arterial blood. The forecast of the medical evacuation is located as well in the direct correlation with the manifestation of acidosis, and at the moment of the completion of the transfer of the patient the greatest prognostic significance they possess the low level of the partial tension of oxygen in the artery. The application of a portable express-analyzer of blood gases permits implementation of correction parameters of respiratory support and to increase quality and safety of the medical evacuation of patients.

Jia L., Wang H., Gao Y., Liu H., Yu K. High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: a prospective, multicenter study in China. Crit. Care. 2016; 20:12.

Kahn J.M., Linde-Zwirble W.T., Wunsch H., Barnato A.E., Iwashyna T.J., Roberts M.S., et al. Potential value of regionalized intensive care for mechanically ventilated medical patients. Am. J. Respir. Crit. Care Med. 2008;177:285-91.

Kanter R.K., Tompkins J.M. Adverse events during interhospital transport: physiologic deterioration associated with pretransport severity of illness. Pediatrics. 1989;84:43-8.

Knight P.H., Maheshwari N., Hussain J., Scholl M., Hughes M., Papadimos T.J., Guo W.A., Cipolla J., Stawicki S.P., Latchana N. Complications during intrahospital transport of critically ill patients: Focus on risk identification and prevention. Int. J. Crit. Illn. Inj. Sci. 2015; 5(4):256-64.

Kreeftenberg H.G.Jr., Ligtenberg J.J., Arnold L.G., van der Werf T.S., Tulleken J.E., Zijlstra J.G. Condition on arrival of transferred critically ill patients. Neth. J. Med. 2000; 57(5):180-4.

Kulshrestha A., Singh J. Inter-hospital and intra-hospital patient transfer: Recent concepts. Indian J. Anaesth. 2016; 60(7): 451-7.

Ligtenberg J.J.M., Arnold L.G., Stienstra Y., van der Werf T.S., Meertens J.H.J.M., Tulleken J.E., et al. Quality of interhospital transport of critically ill patients: a prospective audit. Crit. Care. 2005;9:R446-51.

Mercat A., Richard J.-CM., Vielle B., Jaber S., Osman D., Diehl J.-L. et al. Expiratory Pressure (Express) Study Group: positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2008; 299:646-55.

Moler F.W., Palmisano J.M., Custer J.R., Bartlett R.H. Mechanical ventilation and arterial blood gas measurements 24 hours postextracorporeal life support for survivors of pediatric respiratory failure. Crit. Care Med. 1996;24(4):679-82.

Mueller S.K., Fiskio J., Schnipper J. Interhospital Transfer: Transfer Processes and Patient Outcomes. J. Hosp. Med. 2019;14(8):486-91.

Rouby J-J., Brochard L. Tidal recruitment and over inflation in acute respiratory distress syndrome: yin and yang. Am. J. Respir. Crit. Care Med. 2007;175:104-6.

Szem J.W., Hydo L.J., Fischer E., Kapur S., Klemperer J., Barie P.S. High-risk intrahospital transport of critically ill patients: safety and outcome of the necessary “road trip”. Crit. Care Med. 1995;23(10):1660-6.

Veiga V.C., Postalli N.F., Alvarisa T.K., Travassos P.P., Vale R.T.D.S., Oliveira C.Z., Rojas S.S.O. Adverse events during intrahospital transport of critically ill patients in a large hospital. Rev. Bras. Ter. Intensiva. 2019;31(1):15-20.

Wallen E., Venkataraman S.T., Grosso M.J., Kiene K., Orr R.A. Intrahospital transport of critically ill pediatric patients. Crit. Care Med. 1995; 23:1588-95.

Warren J., Fromm R.E.Jr., Orr R.A., Rotello L.C., Horst H.M. American College of Critical Care Medicine. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit. Care Med. 2004; 32(1):256-62.

Waydhas C., Schneck G., Duswald K.H. Deterioration of respiratory function after intra-hospital transport of critically ill surgical patients. Intensive Care Med. 1995;21(10):784-9.