Objective: To compare the amount of variability in ventilation during intra
hospital transport of intubated pediatric patients ventilated either manual
ly or with a transport ventilator.
Design: Prospective, randomized study.
Setting: Tertiary, multidisciplinary, pediatric intensive care unit.
Patients: Forty-nine pediatric postoperative heart patients who required tr
ansport while still intubated.
Interventions: Patients were randomized to receive either manual ventilatio
n during transport or ventilation by a portable mechanical ventilator. Base
line ventilatory and hemodynamic parameters were recorded before and during
transport. Before and after arterial blood gases were also obtained. All o
ther aspects of care were identical.
Measurements and Main Results: There was a statistically significant greate
r amount of variation in ventilation during trans port with manual techniqu
e as opposed to the mechanical ventilator. A Student's t-test on pre- to po
st-blood gas differences showed a significantly lower Petco(2) (p =.02) in
the manually ventilated patients when compared with the mechanically ventil
ated patients. Values for Pco(2) were higher, but only marginally significa
nt (p =.08). Repeated measures analysis of variance using these same pre- a
nd post blood gas values confirmed the significant decrease in Petco(2) (p
=.05). Minute to minute variation in Petco(2) during transport was greater
and the mean values significantly lower in the manually ventilated group (p
<.05). Hemodynamic data were remarkably stable when examined both before a
nd after transport and on a minute to minute basis during transport.
Conclusions: Manual ventilation during intrahospital transport results in g
reater fluctuation of ventilatory parameters from an established baseline t
han does use of a transport ventilator. No clinically significant changes i
n status occurred during the brief period of transport studied.