Abstract
During the past few decades the numbers of ICUs and beds has increased significantly, but so too has the demand for intensive care. Currently large, and increasing, numbers of critically ill patients require transfer between critical care units. Inter-unit transfer poses significant risks to critically ill patients, particularly those requiring multiple organ support. While the safety and quality of inter-unit and hospital transfers appear to have improved over the years, the effectiveness of specific measures to improve safety have not been confirmed by randomized controlled trials. It is generally accepted that critically ill patients should be transferred by specialized retrieval teams, but the composition, training and assessment of these teams is still a matter of debate. Since it is likely that the numbers and complexity of these transfers will increase in the near future, further studies are warranted.
Highlights
Since the establishment of the first ICUs in the 1950s, the demand for intensive care has grown exponentially
Transfers performed by the referral physicians were associated with a higher incidence of complications, unavailability of equipment, and more frequent requirement for acute interventions upon arrival [45]. This was concordant with an earlier study by Bellingan and colleagues [46] that showed a reduction in acute physiology disturbances and a reduced mortality in critically ill patients transferred by a specialized retrieval team
That most intensive care societies recommend the use of specialized retrieval teams [56,57,58] or at least the use of specific trained personnel [14,15]
Summary
Since the establishment of the first ICUs in the 1950s, the demand for intensive care has grown exponentially. Transfers performed by the referral physicians were associated with a higher incidence of complications, unavailability of equipment, and more frequent requirement for acute interventions upon arrival [45] This was concordant with an earlier study by Bellingan and colleagues [46] that showed a reduction in acute physiology disturbances and a reduced mortality in critically ill patients transferred by a specialized retrieval team. In a survey among the medical heads of all ICUs in the Netherlands published in 2008, escorting personnel and transport facilities were rated as the most important factors in considering whether or not a transfer would be feasible [55] It is no surprise, that most intensive care societies recommend the use of specialized retrieval teams [56,57,58] or at least the use of specific trained personnel [14,15].
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