• G Bellingan, T Olivier, S Batson, and A Webb.
• Bloomsbury Institute of Intensive Care Medicine, Rayne Institute, London, UK.
• Intensive Care Med. 2000 Jun 1;26(6):740-4.

ObjectiveThe inter-hospital transfer of critically ill patients in the United Kingdom is commonly undertaken using standard ambulance under junior doctor escort, despite recommendations for the use of specialist retrieval teams. Patients are transferred into University College London Hospitals (UCLH) intensive care unit (ICU) by both methods. We undertook to evaluate the effect of transfer method on acute physiology (within 2 h of ICU admission) and early mortality ( < 12 h after ICU admission).DesignRetrospective review of all transfers over 1 year.SettingUCLH ICU.Subjects259 transfers; 168 by specialist retrieval team (group A) and 91 by standard ambulance with doctor provided by referring hospital (group B).InterventionsNone.Main Outcome MeasuresAcute physiology (pH, PaO2, PaCO2, heart rate (HR), mean arterial blood pressure (MAP), 24 h severity of illness scores (APACHE II, SAPS II), length of stay and mortality.ResultsThere were no differences in demographic characteristics or severity of illness between the two groups; nevertheless significantly more patients in group B than in group A were severely acidotic (pH < 7.1: 11% vs. 3%, p < 0.008) and hypotensive (MAP < 60: 18 % vs. 9%, p < 0.03) upon arrival. In addition, there were more deaths within the first 12 h after admission with 7.7 % deaths (7/91) in group B transfers vs. 3% (5/168) in group A.ConclusionsThe use of a specialist transfer team may significantly improve the acute physiology of critically ill patients and may reduce early mortality in ICU.

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