Carbon dioxide levels of ventilated adult critically ill post-operative patients on arrival to the intensive care unit
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 ICU. The aim of this study was, therefore, to evaluate the arterial carbon dioxide (PaCO2) levels of ventilated adult critically ill post-operative patients on arrival to 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 PaO2 level (p= 0.0002) and the week and weekend PaCO2 pre-transport (p= 0.00) and post-transport (p= 0.01) 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%), who received a neuromuscular blocking drug compared to those that did not. Adverse events were noted during 12 (26%) 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 PaCO2 level pre- and post-transport and between week and weekend transportations. Hypercarbia was the most common derangement in all transports. Adverse events occurred during one quarter of transportations.
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Anaesthesiology.to the Faculty of Health Sciences, University of the Witwatersrand, 2020