Carbon dioxide levels of ventilated adult critically ill post-operative patients on arrival to the intensive care unit

Abstract

Background. The transportation of critically ill patients presents a precarious situation in which adverse events may occur. At Chris Hani Baragwanath Academic Hospital (CHBAH) patients were manually ventilated using a manual resuscitator bag during transportation from theatre to the intensive care unit (ICU).Objectives. To evaluate the arterial partial pressure of carbon dioxide (PaCO2) levels of ventilated adult critically ill post-operative patients on arrival at the ICU at CHBAH. Methods. This was a cross-sectional study using convenience sampling. Pre- and post-transportation arterial blood gases were obtained from 47 patients. Results. There was a statistically significant difference in the pre- and post-transport PaCO2 level (p=0.03), with a mean difference of 3.3 mmHg. The pre- and post-transport arterial partial pressure of oxygen (PaO2) level (p≤0.001) and the week and weekend pre-transport (p≤0.001) and post-transport (p=0.01) PaCO2 were statistically significantly different. No statistically significant difference was found in the other arterial blood gas parameters or in the post-transport PaCO2 of those patients (26 (55.3%)), who received a neuromuscular blocking drug compared with those that did not. Adverse events were noted during 12 (25.6%) of the transports, 5 (41.7%) of which were patient-related, and 7 (58.3%) of which were infrastructure-related. Conclusion. There was a statistically but not clinically significant difference in the pre- and post-transport PaCO2 level and between week and weekend transportations. Hypercarbia was the most common derangement in all transports. Adverse events occurred during one-quarter of transportations. Keywords: manual resuscitation bag ventilation, transportation of critically ill patients, carbon dioxide levels