Clinical deterioration during neonatal transport in California.
Adult
California
Clinical Deterioration
Congenital Abnormalities
Critical Illness
Female
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases
Infant, Premature
Male
Maternal Age
Regression Analysis
Risk Factors
Time Factors
Transportation of Patients
/ organization & administration
Young Adult
Journal
Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
07
02
2019
accepted:
23
07
2019
revised:
09
07
2019
pubmed:
7
9
2019
medline:
29
9
2020
entrez:
7
9
2019
Statut:
ppublish
Résumé
Identify clinical factors, transport characteristics and transport time intervals associated with clinical deterioration during neonatal transport in California. Population-based database was used to evaluate 47,794 infants transported before 7 days after birth from 2007 to 2016. Log binomial regression was used to estimate relative risks. 30.8% of infants had clinical deterioration. Clinical deterioration was associated with prematurity, delivery room resuscitation, severe birth defects, emergent transports, transports by helicopter and requests for delivery room attendance. When evaluating transport time intervals, time required for evaluation by the transport team was associated with increased risk of clinical deterioration. Modifiable transport intervals were not associated with increased risk. Our results suggest that high-risk infants are more likely to be unstable during transport. Coordination and timing of neonatal transport in California appears to be effective and does not seem to contribute to clinical deterioration despite variation in the duration of these processes.
Identifiants
pubmed: 31488902
doi: 10.1038/s41372-019-0488-5
pii: 10.1038/s41372-019-0488-5
pmc: PMC7223687
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
377-384Références
Lupton BA, Pendray MR. Regionalized neonatal emergency transport. Semin Neonatol. 2004;9:125–33.
doi: 10.1016/j.siny.2003.08.007
Marlow N, Bennett C, Draper ES, Hennessy EM, Morgan AS, Costeloe KL. Perinatal outcomes for extremely preterm babies in relation to place of birth in England: the EPICure 2 study. Arch Dis Child Fetal Neonatal Ed. 2014;99:F181–188.
doi: 10.1136/archdischild-2013-305555
Warner B, Musial MJ, Chenier T, Donovan E. The effect of birth hospital type on the outcome of very low birth weight infants. Pediatrics. 2004;113(1 Pt 1):35–41.
doi: 10.1542/peds.113.1.35
Apfeld JC, Kastenberg ZJ, Sylvester KG, Lee HC. The effect of level of care on gastroschisis outcomes. J Pediatr. 2017;190:79–84.e1.
doi: 10.1016/j.jpeds.2017.07.008
Kastenberg ZJ, Lee HC, Profit J, Gould JB, Sylvester KG. Effect of deregionalized care on mortality in very low-birth-weight infants with necrotizing enterocolitis. JAMA Pediatr. 2015;169:26–32.
doi: 10.1001/jamapediatrics.2014.2085
Lapcharoensap W, Gage SC, Kan P, Profit J, Shaw GM, Gould JB, et al. Hospital variation and risk factors for bronchopulmonary dysplasia in a population-based cohort. JAMA Pediatr. 2015;169:e143676.
doi: 10.1001/jamapediatrics.2014.3676
Hohlagschwandtner M, Husslein P, Klebermass K, Weninger M, Nardi A, Langer M. Perinatal mortality and morbidity. Comparison between maternal transport, neonatal transport and inpatient antenatal treatment. Arch Gynecol Obstet. 2001;265:113–8.
doi: 10.1007/s004040100197
Araújo BF, Zatti H, Oliveira Filho PF, Coelho MB, Olmi FB, Guaresi TB, et al. Effect of place of birth and transport on morbidity and mortality of preterm newborns. J Pediatr. 2011;87:257–62.
Mohamed MA, Aly H. Transport of premature infants is associated with increased risk for intraventricular haemorrhage. Arch Dis Child Fetal Neonatal Ed. 2010;95:F403–407.
doi: 10.1136/adc.2010.183236
Towers CV, Bonebrake R, Padilla G, Rumney P. The effect of transport on the rate of severe intraventricular hemorrhage in very low birth weight infants. Obstet Gynecol. 2000;95:291–5.
pubmed: 10674596
Lee SK, Zupancic JA, Pendray M, Thiessen P, Schmidt B, Whyte R, et al. Transport risk index of physiologic stability: a practical system for assessing infant transport care. J Pediatr. 2001;139:220–6.
doi: 10.1067/mpd.2001.115576
Gould JB, Danielsen BH, Bollman L, Hackel A, Murphy B. Estimating the quality of neonatal transport in California. J Perinatol. 2013;33:964–70.
doi: 10.1038/jp.2013.57
Sample M, Acharya A, O’Hearn K, Livingstone S, Menon K. The relationship between remoteness and outcomes in critically ill children. Pediatr Crit Care Med. 2017;18:e514–20.
doi: 10.1097/PCC.0000000000001318
Mori R, Fujimura M, Shiraishi J, Evans B, Corkett M, Negishi H, et al. Duration of inter-facility neonatal transport and neonatal mortality: systematic review and cohort study. Pediatr Int. 2007;49:452–8.
doi: 10.1111/j.1442-200X.2007.02393.x
CPQCC Manual of Definitions For Infants Born in 2018. California Care Quality Care Collaborative, Stanford, CA; 2018.
Akula VP, Gould JB, Kan P, Bollman L, Profit J, Lee HC. Characteristics of neonatal transports in California. J Perinatol. 2016;36:1122–7.
doi: 10.1038/jp.2016.102
Frid I, Ågren J, Kjellberg M, Normann E, Sindelar R. Critically ill neonates displayed stable vital parameters and reduced metabolic acidosis during neonatal emergency airborne transport in Sweden. Acta Paediatr. 2018;107:1357–61.
doi: 10.1111/apa.14295
Eliason SH, Whyte H, Dow K, Cronin CM, Lee S, Network CN. Variations in transport outcomes of outborn infants among Canadian neonatal intensive care units. Am J Perinatol. 2013;30:377–82.
doi: 10.1055/s-0032-1324706
Abdel-Latif ME, Berry A. Analysis of the retrieval times of a centralised transport service, New South Wales, Australia. Arch Dis Child. 2009;94:282–6.
doi: 10.1136/adc.2007.125211