What are the transfer considerations for patients with acute respiratory distress syndrome (ARDS)?

Updated: Mar 27, 2020
  • Author: Eloise M Harman, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Once the acute phase of ARDS resolves, patients may require a prolonged period to be weaned from mechanical ventilation and to regain muscle strength lost after prolonged inactivity. This may necessitate transfer to a rehabilitation facility once the acute phase of the illness is resolved.

Transfer of the ARDS patient to a tertiary care facility may be indicated in some situations, provided that safe transport can be arranged. Transfer may be indicated if the FIO2 cannot be lowered to less than 0.65 within 48 hours.

Other patients who may potentially benefit from transfer include those who have experienced pneumothorax and have persistent air leaks, patients who cannot be weaned from mechanical ventilation, patients who have upper airway obstruction after prolonged intubation, or those with a progressive course in which an underlying cause cannot be identified.

If ARDS develops in a patient who previously has undergone organ or bone marrow transplantation, transfer to an experienced transplant center is essential for appropriate management.


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