• A Chieregato, G Paci, L Portolani, M Ravaldini, C Fabbri, C Martino, E Russo, and B Simini.
• Anaesthesia and Intensive Care Unit, AOU Careggi, Florence, Italy.
• Anaesthesia. 2014 Oct 1;69(10):1117-26.

AbstractThis study aimed to gauge the opinions of patients' next of kin regarding transfer of patients from the specialist 'Hub' intensive care unit, to 'Spoke' intensive care units near home. We included 213 consecutive patients with severe trauma or severe acute neurological conditions admitted to the Hub intensive care unit over a 21-month period, who were repatriated to Spoke intensive care units for ongoing intensive care. One year after admission to the Hub intensive care unit, two thirds of patients' next of kin said they would have preferred patients to have been treated only in the Hub intensive care unit, and not repatriated. They perceived Hub intensive care unit care to be important, and would have preferred that their relatives be hospitalised there until intensive treatment was completed. The next of kin's preference was associated with severe acute neurological conditions (p ≤ 0.0001). Although centralised Hub & Spoke intensive care unit networks are appropriate to ensure specialised care, repatriation to local hospitals may not be appropriate for patients with severe neurological conditions.© 2014 The Association of Anaesthetists of Great Britain and Ireland.

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