• Ari Uusaro, Ilkka Parviainen, Jukka Takala, and Esko Ruokonen.
• Kuopio University Hospital, Critical Care Research Program, Department of Anesthesiology and Intensive Care, Division of Critical Care, PO Box 1777, 70211, Kuopio, Finland. ari.uusaro@kuh.fi
• Intensive Care Med. 2002 Aug 1;28(8):1122-5.

ObjectiveTo assess the safety of long-distance ground interhospital transport of critically ill patients with the most severe unstable respiratory failure after establishment of a dedicated transport system.Design And SettingCohort study, retrospective chart review in 13 hospitals and intensive care units (ICU) in Finland, and a tertiary referral center and ICU of a university hospital.Patients66 consecutive critically ill patients who were transferred to our ICU from 13 different ICUs in Finland because of severe, progressive respiratory failure, 52 (79%) with acute respiratory distress syndrome.Measurements And ResultsMajor complications during transfer and patients' oxygenation. The median transfer distance was 161 km (range 120-460 km). Drugs for cardiovascular support were infused in 59 patients (89%) during transfer. Fourteen patients (21%) were transferred in prone position because of life-threatening hypoxemia. The ratio of arterial blood PaO(2) and the fraction of oxygen in the ventilator was 8.5+/-2.7 kPa (64+/-20 mmHg) before transfer and 9.7+/-3.6 kPa (73+/-27 mmHg) after transfer. There were no major complications during the transfer. ICU mortality was 30%.ConclusionsLong-distance interhospital ground transfer of even critically ill patients with severe unstable respiratory and circulatory failure is safe if a dedicated transport team and a specially equipped transport vehicle are used.

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