HERMES: International Survey and Portable External Power Evaluation During Respiratory Support Transport

NCT07807189 | Completed

• 1 other identifier: IANIV-HERMES-I-II
• Study Type: observational
• Target: 246
• Locations: 14 countries
• Sites: 20

Brief Summary

The HERMES Phase I-II study was a two-phase observational investigation designed to characterize contemporary practices and safety-related challenges associated with the transport of patients requiring advanced respiratory support and to assess the operational feasibility of portable external electrical power during ambulance transport. Phase I consisted of an international electronic cross-sectional survey of healthcare professionals involved in noninvasive ventilation (NIV) management or patient transport. The survey evaluated reported transport indications, ventilator type and positioning, respiratory interfaces, transport-team composition, and perceived patient-, equipment-, and environment-related problems. Phase II was a prospective descriptive feasibility evaluation involving 25 ambulance transports performed in Albacete and Bilbao, Spain. Patients were transported while receiving high-flow nasal oxygen (HFNO), rescue NIV, or invasive mechanical ventilation. A portable external power supply was used to support continuity of powered respiratory-support equipment during transport. The primary technical feasibility outcome was successful completion of transport while maintaining respiratory support without reported power interruption, clinically relevant equipment alarm, or technical failure. The two phases were analyzed independently and were intended to characterize respiratory-support transport practices and evaluate technical and operational feasibility rather than establish comparative effectiveness, clinical superiority, or prevention of clinical deterioration.

Conditions

Patient Transport; Respiratory Failure; Noninvasive Ventilation; High-Flow Nasal Oxygen; Mechanical Ventilation; Patient Safety; Transport Safety; Medical Equipment Safety; Electrical Power Continuity

Keywords

Patient Transport; Intrahospital Transport; Interhospital Transport; Prehospital Transport; Noninvasive Ventilation; High-Flow Nasal Oxygen; Mechanical Ventilation; Advanced Respiratory Support; Transport Safety; Patient Safety; Portable External Power; Electrical Power Continuity; Critical Care Transport; Respiratory Support; Equipment-Related Events

Outcome Measures

Primary Outcomes (2)

• Number and Percentage of Respondents Reporting Predefined Respiratory-Support Transport Practices

  Number and percentage of Phase I survey respondents reporting predefined respiratory-support transport practices, including transport indications, ventilator type and positioning, respiratory-interface use, and transport-team composition.

  Baseline

• Number and Percentage of Ambulance Transports Completed With Uninterrupted Respiratory Support

  Number and percentage of Phase II ambulance transport episodes completed with uninterrupted respiratory support and without reported electrical power interruption, clinically relevant equipment alarm, or technical failure. This outcome represented the primary technical feasibility measure of the portable external power evaluation.

  From departure from the point of origin to arrival at the intended destination (transport duration: 23-110 minutes)

Secondary Outcomes (6)

• Number and Percentage of Respondents Reporting Transport-Related Problems

  Baseline

• Number and Percentage of Respondents Reporting Each Transport-Team Professional Category

  Baseline

• Number and Percentage of Ambulance Transports by Respiratory-Support Modality

  From departure from the point of origin to arrival at the intended destination (transport duration: 23-110 minutes)

• Number and Percentage of Patients Requiring Escalation or Modification of Respiratory Support

  From departure from the point of origin to arrival at the intended destination (transport duration: 23-110 minutes)

• Number and Percentage of Ambulance Transports With Power Interruption, Clinically Relevant Equipment Alarm, or Technical Failure

  From departure from the point of origin to arrival at the intended destination (transport duration: 23-110 minutes)

Study Arms (2)

Phase I - International Healthcare Professional Survey

Healthcare professionals involved in noninvasive ventilation management or patient transport who participated in the international electronic cross-sectional survey. The survey assessed reported transport indications, ventilator type and positioning, respiratory-interface use, transport-team composition, and perceived patient-, equipment-, and environment-related problems. The survey dataset contained 224 response records corresponding to 221 unique respondents.

Phase II - Portable External Power Feasibility Cohort

Patients undergoing ambulance transport while receiving advanced respiratory support, including high-flow nasal oxygen, rescue noninvasive ventilation, or invasive mechanical ventilation. Portable external electrical power was prospectively evaluated for continuity of powered respiratory-support equipment during transport. Clinical management and respiratory-support decisions were determined according to routine clinical practice.

Device: Portable External Power Supply

Interventions

Portable External Power Supply DEVICE

A Zopec Transport UPS 90 portable external power supply was used during ambulance transport to provide continuous electrical power to powered respiratory-support equipment. The feasibility evaluation assessed maintenance of respiratory support during transport and the occurrence of power interruption, clinically relevant equipment alarms, or technical failure.

Phase II - Portable External Power Feasibility Cohort

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population comprised two distinct groups. Phase I included healthcare professionals involved in noninvasive ventilation management or patient transport who participated in an international electronic cross-sectional survey addressing respiratory-support transport practices. Phase II included patients undergoing ambulance transport while receiving advanced respiratory support, including high-flow nasal oxygen, noninvasive ventilation, or invasive mechanical ventilation, in participating units in Albacete and Bilbao, Spain. The two populations were analyzed separately and were not statistically combined.

You may qualify if:

• Healthcare professionals involved in the management of noninvasive ventilation or in the transport of patients requiring respiratory support.
• Participation in the international electronic survey addressing respiratory-support transport practices.

You may not qualify if:

• Records not representing participation in the respiratory-support transport survey.
• Records lacking sufficient information for descriptive analysis of the predefined survey domains.
• Phase II - Portable External Power Feasibility Evaluation
• Patients undergoing ambulance transport while receiving advanced respiratory support.
• Receipt of high-flow nasal oxygen (HFNO), noninvasive ventilation (NIV), or invasive mechanical ventilation during the transport episode.
• Transport performed at one of the participating clinical units included in the prospective feasibility evaluation.
• Availability of transport-level data sufficient to evaluate continuity of respiratory support and the occurrence of power interruption, clinically relevant equipment alarm, or technical failure.
• Transport episodes not involving advanced respiratory support.
• Transport episodes for which continuity of respiratory support or the primary technical feasibility outcome could not be determined.

Sponsors & Collaborators

• Medipol University: lead

Study Sites (20)

Department Pulmonary Critical Care and Sleep Medicine Northwell Northern Westchester Hospital

Mount Kisco, New York, 10549, United States

Location

Intensive care Unit, Hospital General Ramos Mejia, Buenos Aires Argentina School of Medicine, University of Magallanes

Punta Arenas, Chile

Location

Faculty of Health Sciences, Universidad Autónoma de Chile

Santiago, Chile

Location

Department of Anaesthesiology and ICU, University Hospital Centre Zagreb

Zagreb, Croatia

Location

Chest Department, Cairo University Hospitals

Cairo, Egypt

Location

Department of Respiratory Medicine, Father Muller Medical College Hospital

Mangalore, India

Location

Shahid Beheshti University of Medical Sciences

Tehran, Iran

Location

Department of Critical Care, UOC Anesthesia, Postoperative Intensive Care and ECMO, Monaldi Hospital, AORN Ospedali dei Colli

Naples, Italy

Location

Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Servicio de Neumología

Mexico City, Mexico

Location

Department of Medicine, College of Medicine and Health Sciences, National University of Science and Technology

Sohar, Oman

Location

Heart Hospital, HMC

Doha, Qatar

Location

Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University

Jeddah, Saudi Arabia

Location

Mobile Emergency Unit of Albacete, Department of Urgent Care, Emergencies and Medical Transport of Castilla-La Mancha

Albacete, Spain

Location

Intensive Care Unit, Hospital Punta de Europa

Algeciras, Spain

Location

Emergentziak, Osakidetza

Bilbao, Spain

Location

Intensive Care Unit. Hospital Morales Meseguer

Murcia, Spain

Location

Department of Pulmonology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University

Hatay, Turkey (Türkiye)

Location

İstanbul Medipol University

Istanbul, Turkey (Türkiye)

Location

Al-Razi University

Sanaa, Yemen

Location

Department of Respiratory Therapy, Ibn- al-Nafis University for Medical Sciences

Sanaa, Yemen

Location

Related Publications (9)

• Williams P, Karuppiah S, Greentree K, Darvall J. A checklist for intrahospital transport of critically ill patients improves compliance with transportation safety guidelines. Aust Crit Care. 2020 Jan;33(1):20-24. doi: 10.1016/j.aucc.2019.02.004. Epub 2019 Apr 10.

  PMID: 30981603 BACKGROUND

• Jia L, Wang H, Gao Y, Liu H, Yu K. High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors: a prospective, multicenter study in China. Crit Care. 2016 Jan 18;20:12. doi: 10.1186/s13054-016-1183-y.

  PMID: 26781179 BACKGROUND

• Schwebel C, Clec'h C, Magne S, Minet C, Garrouste-Orgeas M, Bonadona A, Dumenil AS, Jamali S, Kallel H, Goldgran-Toledano D, Marcotte G, Azoulay E, Darmon M, Ruckly S, Souweine B, Timsit JF; OUTCOMEREA Study Group. Safety of intrahospital transport in ventilated critically ill patients: a multicenter cohort study*. Crit Care Med. 2013 Aug;41(8):1919-28. doi: 10.1097/CCM.0b013e31828a3bbd.

  PMID: 23863225 BACKGROUND

• Jeyaraju M, Andhavarapu S, Palmer J, Bzhilyanskaya V, Friedman E, Lurie T, Patel P, Raffman A, Wang J, Tran QK. Safety Matters: A Meta-analysis of Interhospital Transport Adverse Events in Critically Ill Patients. Air Med J. 2021 Sep-Oct;40(5):350-358. doi: 10.1016/j.amj.2021.04.008. Epub 2021 May 24.

  PMID: 34535244 BACKGROUND

• Murata M, Nakagawa N, Kawasaki T, Yasuo S, Yoshida T, Ando K, Okamori S, Okada Y. Adverse events during intrahospital transport of critically ill patients: A systematic review and meta-analysis. Am J Emerg Med. 2022 Feb;52:13-19. doi: 10.1016/j.ajem.2021.11.021. Epub 2021 Nov 20.

  PMID: 34861515 BACKGROUND

• Fanara B, Manzon C, Barbot O, Desmettre T, Capellier G. Recommendations for the intra-hospital transport of critically ill patients. Crit Care. 2010;14(3):R87. doi: 10.1186/cc9018. Epub 2010 May 14.

  PMID: 20470381 BACKGROUND

• Warren J, Fromm RE Jr, Orr RA, Rotello LC, Horst HM; American College of Critical Care Medicine. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit Care Med. 2004 Jan;32(1):256-62. doi: 10.1097/01.CCM.0000104917.39204.0A.

  PMID: 14707589 BACKGROUND

• Oczkowski S, Ergan B, Bos L, Chatwin M, Ferrer M, Gregoretti C, Heunks L, Frat JP, Longhini F, Nava S, Navalesi P, Ozsancak Ugurlu A, Pisani L, Renda T, Thille AW, Winck JC, Windisch W, Tonia T, Boyd J, Sotgiu G, Scala R. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. Eur Respir J. 2022 Apr 14;59(4):2101574. doi: 10.1183/13993003.01574-2021. Print 2022 Apr.

  PMID: 34649974 BACKGROUND

• Rochwerg B, Brochard L, Elliott MW, Hess D, Hill NS, Nava S, Navalesi P Members Of The Steering Committee, Antonelli M, Brozek J, Conti G, Ferrer M, Guntupalli K, Jaber S, Keenan S, Mancebo J, Mehta S, Raoof S Members Of The Task Force. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017 Aug 31;50(2):1602426. doi: 10.1183/13993003.02426-2016. Print 2017 Aug.

  PMID: 28860265 BACKGROUND

MeSH Terms

Conditions

Respiratory Insufficiency

Condition Hierarchy (Ancestors)

Respiration Disorders; Respiratory Tract Diseases

Study Officials

• Antonio Esquinas

  Intensive Care Unit, Hospital Meseguer, Murcia, Spain

  STUDY DIRECTOR

• Berkan Basançelebi

  Medipol University

  STUDY CHAIR

• Satheesh Munusamy

  Heart Hospital, HMC, Qatar

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: August 25, 2026
• First Posted: September 8, 2026
• Study Start: February 20, 2023
• Primary Completion: May 20, 2023
• Study Completion: February 20, 2025
• Last Updated: September 9, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ANALYTIC CODE
• Time Frame: Deidentified individual participant data and available supporting information may be made available beginning 6 months after publication of the primary study results and for up to 5 years thereafter.
• Access Criteria: Deidentified individual participant data underlying the published results may be made available to qualified researchers upon reasonable request. Requests must include a scientifically justified and methodologically appropriate research proposal and will be reviewed by the HERMES Steering Committee. Access will be limited to data necessary for the approved analysis and will remain subject to applicable ethics approvals, participant consent provisions, institutional policies, and data-protection regulations. Variables that cannot be adequately deidentified or are restricted by ethical, legal, or institutional requirements will not be shared. A data-use agreement may be required before access is granted.

Locations

YE (2); IR (1); ME (1); CL (2); OM (1); TU (2); QA (1); CR (1); SA (1); IT (1); EG (1); ES (4); IN (1); US (1)