[The transport of severely ill children in the Amsterdam region; 1995-2001].

OBJECTIVE: To inventory experiences of the transport of critically ill children in the Amsterdam region.

DESIGN: Retrospective, observational.

METHOD: Data were collected from the 1299 children who were transported to our paediatric intensive-care unit from 1 January 1995 until 31 December 2001. Severity of illness was scored and mortality risk calculated. Data on 535 children who were retrieved by our intensive-care team were compared to those from the 764 who were attended by the referring team. The impact on the outcome of distance and duration of transports from both inside and outside the Amsterdam region was analyzed.

RESULTS: Two thirds of the transports took place during the evening and night. The median age of the children was 7.5 months. Main indication for admission was respiratory or circulatory insufficiency. During the stabilizing procedure before retrieval, one or more interventions were conducted by our team in 368 (69%) of the 535 retrieved children. 940 children were transported within our region. There were no significant differences between retrieval and non-retrieval groups with respect to length of stay, length of ventilation and mortality. In patients from outside our region the mortality in the retrieval group was higher than in the non-retrieval group.

CONCLUSION: Retrieval by a specialized team did not always contribute to a favourable outcome. However, from both a logistical and a medical point of view, a retrieval system seems warranted in order to guarantee a higher level of care. There is a need for more clarity regarding the indications for retrieval by an intensive-care team.