Impact of Land-Based Neonatal Transport on Outcomes in Transient Tachypnea of the Newborn

Abstract

We sought to determine the effect of neonatal transport on the incidence of adverse events of transient tachypnea of the newborn (TTN) in term neonates. A retrospective study was performed of neonates who had TTN and were admitted to Neonatal Intensive Care Unit (NICU) of Sami Ulus Maternity, Children's Education and Research Hospital by land-based transport. Data from 208 newborns with TTN were evaluated, and clinical and laboratory findings were compared between patients who were transported from within the city (group 1) or from outside of the city (group 2). In the present study, long-distance land-based neonatal transport increased the adverse effects of TTN in newborns. Arterial blood gas parameters of the neonates in both groups before transport were similar, and these parameters and Downes' scores were comparable in both groups, implying that patients from outside the city had greater respiratory insufficiency than those from inside the city at admission to NICU. Respiratory support in the NICU and pulmonary air leak syndrome ratios were found to be significantly higher in the group from outside the city. Long-distance land-based transport in neonates with TTN increases the severity of illness. Furthermore, adverse events and the outcome of such infants depend on the effectiveness of the neonatal transport system.

Pneumothorax in neonates: Trends, predictors and outcomes

“…Male sex as a risk factor for pneumothorax is well established [5,7]. The evidence regarding the impact of outborn status on pneumothorax is conflicting [8,10,11]. Whereas CPAP was protective in early preterm neonates, CPAP was a risk factor for pneumothorax in moderate-late preterm and term neonates.…”

“…In term neonates, risk factors for pneumothorax include positive pressure ventilation, meconium aspiration, active resuscitation, male sex, and being larger in size [5][6][7]. Cesarean delivery [5,7] and birth outside a tertiary perinatal center [8][9][10][11] have also been suggested as risk factors for pneumothorax, but the evidence is conflicting. Furthermore, the majority of previous studies of pneumothorax were limited to single centers with small sample sizes and low statistical power [4][5][6][7].…”

Impact of Interhospital Transport on the Physiologic Status of Very Low-Birth-Weight Infants

“…These results in VLBW infants are congruent with prior reports on neonatal transport. 4,10,14 Among the individual TRIPS variables, the impact on transport outcomes for VLBW infants appears to be related to temperature regulation; accounting for a change in the physiologic status of 79% of the study infants. Longer transport durations in neonates may result in inadequate control of body temperatures, which can potentially increase the morbidity and mortality in this high-risk population.…”

“…Few previous studies on transport of pediatric trauma patients in population-sparse areas have shown that longer duration of transport is associated with higher mortality and morbidity. 8,9 In a recent study of 208 infants with transient tachypnea of newborn (TTN), Karagol et al 10 showed that long-distance land-based transport in neonates with TTN increases the severity of illness.…”

Assessing Outcome in Interhospital Infant Transport: The Transport Risk Index of Physiologic Stability Score at Admission

“…The recognized risks of transferring critically ill patients by ambulance or air transport are associated with a high incidence of serious hemodynamic or respiratory instability. 1,2 Four scores are used to assess transported infants, each with inherent advantages and disadvantages. [3][4][5][6] The Transport Risk Index of Physiologic Stability (TRIPS) 5 was originally designed to assess infant status before and after transport.…”