Intra-hospital transport of adult critically ill patients treated with high flow nasal cannula oxygen: a prospective observational multicenter study.

IF 5.5 1区医学 Q1 CRITICAL CARE MEDICINE

Annals of Intensive Care Pub Date : 2025-07-08 DOI:10.1186/s13613-025-01502-7

Mai-Anh Nay, Alice Bisson, Adrien Auvet, Agathe Delbove, Aziz Berrouba, Toufik Kamel, Maxime Desgrouas, Thierry Boulain

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Abstract

Background: Acute respiratory failure is a common reason for admission to the intensive care unit, and patients are frequently treated with high-flow nasal cannula oxygen therapy (HFNC). Intra-hospital transport of critically ill patients, such as between hospital wards and the intensive care unit or for diagnostic exams, is common. Transportable HFNC can be used during these intra-hospital transports. We aimed to evaluate the complications associated with intra-hospital transport of patients treated with HFNC.

Methods: We conducted a prospective, descriptive multicenter study between May 2022 and May 2024, involving critically ill adult patients who were treated with HFNC prior to transport and required intra-hospital transport for any reason, accompanied by an intensive care unit team. The primary objective was to evaluate the incidence of severe adverse events including severe hypoxemia (with pulse oxygen saturation of less than 80%), need for intubation, need for non-invasive ventilation or cardiorespiratory arrest during transport. Secondary objectives were to assess the incidence of non-severe adverse events, defined as the need for increased inspired oxygen fraction, switching HFNC for standard oxygen therapy, nasal cannula removal or dysfunction of the HFNC device.

Results: We included 165 patients and analyzed 187 transports. Eight (4.3%) severe adverse events occurred in 7 patients including 6 cases of severe transient hypoxemia and 2 cases of non-invasive ventilation. All of them were transient severe hypoxemia that occurred during the first transport. Forty-three (23%) non-severe adverse events occurred, including 29(15.6%) cases of increased inspired oxygen fraction requirement, 7/187 (3.74%) cases of nasal cannula removal, 6/187 (3.2%) cases of HFNC device dysfunction, and 1 (0.5%) case involved replacing HFNC with standard oxygen therapy.

Conclusion: HFNC during intra-hospital transport of critically ill patients had a low incidence of severe adverse events. Non-severe adverse events were more frequent, but their potential impact could not be assessed in this study and warrants further investigation.

Trial registration: Clinicalstrials.gov, NCT05311007, registered 23 March 2022, https://clinicaltrials.gov/study/NCT05311007?term=hospiflow&rank=1 .

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高流量鼻插管供氧治疗成人危重患者的院内转运：一项前瞻性观察性多中心研究

背景：急性呼吸衰竭是入住重症监护室的常见原因，患者经常采用高流量鼻插管氧疗（HFNC）治疗。在医院内运送危重病人，例如在医院病房和重症监护病房之间或进行诊断检查，是很常见的。可移动的HFNC可用于这些院内运输。我们的目的是评估HFNC患者院内转运的相关并发症。方法：我们在2022年5月至2024年5月期间进行了一项前瞻性、描述性多中心研究，纳入了在转运前接受HFNC治疗并因任何原因需要在重症监护病房团队陪同下进行院内转运的危重成人患者。主要目的是评估严重不良事件的发生率，包括严重低氧血症（脉搏氧饱和度低于80%）、需要插管、需要无创通气或运输过程中心肺骤停。次要目的是评估非严重不良事件的发生率，定义为需要增加吸入氧分数，将HFNC转换为标准氧治疗，鼻插管取出或HFNC装置功能障碍。结果：我们纳入了165例患者，分析了187例转运。7例患者发生严重不良事件8例（4.3%），其中6例为严重一过性低氧血症，2例为无创通气。所有病例均为首次转运时发生的短暂性严重低氧血症。发生43例（23%）非严重不良事件，包括吸入氧分数需要量增加29例（15.6%），鼻插管拔除7例（3.74%），HFNC装置功能障碍6例（3.2%），标准氧疗替代HFNC 1例（0.5%）。结论：HFNC在危重患者院内转运过程中严重不良事件发生率低。非严重不良事件更频繁，但其潜在影响无法在本研究中评估，需要进一步调查。试验注册：clinicaltrials.gov, NCT05311007，注册于2022年3月23日，https://clinicaltrials.gov/study/NCT05311007?term=hospiflow&rank=1。

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来源期刊

Annals of Intensive Care CRITICAL CARE MEDICINE-

CiteScore

14.20

自引率

3.70%

发文量

107

审稿时长

13 weeks

期刊介绍： Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.