Transport of critical patient for radiodiagnostic examinations: Effects on treatment, complications and cost

The aim of our study was to evaluate transport-related complications in patients transported from intensive care unit (ICU) for radiodiagnostic examinations, and the effects and costs of examinations. After the decision of Bursa Uludağ University Medical Research Ethics Committee dated 24/10/2017 and numbered 2017-15/22, 111 intra-hospital transports performed between November 2017 and March 2019 of 100 patients treated in Department of Anesthesiology and Reanimation ICU were prospectively evaluated. Among transported patients, 13(11%) developed circulatory, 19(17%) respiratory and 8(7%) device related complications. In the patients with circulatory complications, the rates of; patients older than 50 years, APACHE II score >19 and vasoactive/inotropic drug use and device complications were significantly higher (p=0.22, p=0.001, p=0.006, p=0.00, respectively). The rate of sedation use and device complications were significantly higher in patients with respiratory complications (p=0.026, p=0.028, respectively). The rate of patients with APACHE II score >19 was significantly higher in patients with device complications (p = 0.022). Body temperature of cases transported in an average of 32.6±16.4 minutes decreased significantly (mean from 37.4 to 36.9). A new imaging finding was detected in 65(58.6%) of the transport cases. 34(52%) of these tests resulted in change in treatment. The cost of radiodiagnostic examinations was 6871 Turkish Liras (TL). 64.5% of the total cost was arisen from findings detected in imaging, whereas 40.3% was arisen from examinations with changes in post-transport therapy. In conclusion, It was determined that during transport, respiratory and circulatory complications such as tachycardia and desaturation may develop in critical patients, and oxygen supply might be interrupted. Thus a more appropriate approach would be taking transport decisions, by taking benefit/loss ratio and the contribution of requested investigations, to treatment of these patients into account. Keywords: Critical patient, transport, radiodiagnostic, complication, cost