Aeromedical Retrieval of Critically Ill Pulmonary Embolism Patients: A Retrospective Cohort Study of 10 Years in New South Wales.
Heart, lung & circulation · 2025-10-30 · Observational study
Abstract
BACKGROUND: Pulmonary embolism (PE) is a common, time-critical condition requiring multidisciplinary care. Interhospital transport is a high-risk period in the patient's care but offers an opportunity for expedited risk stratification, resuscitation, and transport to definitive care. Patients who require interhospital transfer to specialist centres for PE management have worse outcomes. Despite this, the literature surrounding the interhospital retrieval practice and experience of PE is limited. METHOD: A retrospective cohort study was conducted over a 10-year period from January 2014 to June 2024 from the database of a high-volume aeromedical retrieval service in New South Wales, Australia. The study aimed to describe this service's experience in the care of critically ill patients with PE requiring interhospital transport. RESULTS: This study included 132 patients in the final analysis, of which 55% were risk stratified as being high risk by European Society of Cardiology criteria. In total, 40% of patients were transferred for specific predetermined advanced PE therapies including extracorporeal support, and 28% of patients received non-thrombolysis advanced PE therapies in the first 24 hours post-transfer. Clinically significant deteriorations in transit occurred in 37% of patients, of which the most common complication was new haemodynamic deterioration (17%). CONCLUSIONS: The population of patients requiring aeromedical retrieval for PE in New South Wales have a high severity of illness, are labour intensive for the retrieval service and frequently deteriorate during transport. Early coordination of care and close collaboration between the retrieval team and the specialist receiving teams offer an opportunity to optimise care.