Transport risk index of physiologic stability: A practical system for assessing infant transport care

Lee, Shoo K.; Zupancic, John A.F.; Pendray, Margaret; Thiessen, Paul; Schmidt, Barbara; Whyte, Robin; Shorten, David; Stewart, Shawn

doi:10.1067/mpd.2001.115576

Cited by 132 publications

(100 citation statements)

References 16 publications

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“…La elección de este puntaje para nuestro estudio se basó en la facilidad de su medición, ya que los parámetros que se utilizan para su cálculo son sencillos de medir, tanto por el médico derivante como por el receptor y no dependen de determinaciones de laboratorio ni de impresiones subjetivas, lo cual evita la variabilidad inter-observadores y, por lo tanto, los sesgos en la medición. Adicionalmente, tal como ocurrió en el informe original 6 encontramos que el aumento del valor del TRIPS después del transporte se asoció con la mortalidad de los RN, lo cual refleja la importancia del cuidado neonatal en esta etapa.…”

Section: Discussionunclassified

Factores de riesgo asociados a deterioro clínico en el traslado de recién nacidos enfermos

et al. 2012

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Arch Argent Pediatr 2012;110(4):304-310 / 304 RESUMEN El traslado neonatal adecuado es clave en el cuidado de recién nacidos (RN) que requieren derivación. Objetivo. Determinar las características y el riesgo de deterioro clínico (DC) durante el traslado neonatal. Material y métodos. Estudio observacional y prospectivo; se incluyeron en forma consecutiva RN derivados a la UCIN del Hospital Garrahan. Se midió el puntaje TRIPS (Transport Risk Index of Physiology Stability) antes del traslado y después de él. Se consideró DC del RN cuando el TRIPS postraslado era mayor que el pretraslado. Se registraron características del RN, tipo de enfermedad, distancia, condición al ingreso, necesidad de soporte cardiorrespiratorio inmediato (SCRI) y óbito antes del 7° día y al alta. Se empleó análisis bivariado y multivariado para buscar asociaciones con el DC. Resultados. Se evaluaron 160 RN (EG 35 ± 3 sem, PN 2482 ± 904 g) con una mediana de 2 días de edad, derivados por enfermedades cardiorrespiratorias (50%) y quirúrgicas (34%) en su mayoría. En 57% (91) se observó DC; 46% presentó hipotermia. Requirieron SCRI 49 RN, 28 fallecieron (12 antes del 7º día de ingreso). Las variables estudiadas no se asociaron con el riesgo de DC. La mortalidad fue mayor en el grupo con DC (OR: 3,34 IC 95%: 1,2-8,7), aún luego de considerar la gravedad del RN (OR A : 3 IC 95%: 1,2-8,3). El DC se asoció con necesidad de SCRI (OR: 2,4 IC 95%: 1,2-5). Conclusiones. Los RN trasladados sufren con frecuencia pérdida de estabilidad o deterioro clí-nico independientemente de sus características; esto se relaciona con mayor mortalidad. Resulta imprescindible que se optimicen las estrategias de cuidado en todos los traslados neonatales. Clinical deterioration (CD) was considered when TRIPS value at admission was higher than the prior transportation value. We registered: diagnosis, distance, admission condition, immediate cardiorespiratory support (ICRS) requirement, and death before 7 th day, and at discharge. Associations with CD we evaluated by bivariate and multivariate analysis. Results. A total of 160 transferred NB were enrolled (GA: 35 ± 3 w, BW: 2482 ± 904 g), median 2 days, mostly due to cardiorespiratory (50%) or surgical (34%) illness. CD was observed; in 57% of the cases (91) furthermore, 46% presented hypothermia. Forty nine NB required ICRS, 28 died (12 before 7 th day). Studied variables were not associated with risk of CD. Mortality was higher in the deterioration group (24%) (OR 3,34; IC 95% 1,2-8,7), also when were considered NB risk (OR A 3; IC 95% 1,2-8,3). Clinical deterioration during transportation was associated with SCRI (OR 2,4; IC 95% 1,2-5). Conclusions. Transferred NB often loose stability or has CD, independently of their characteristics, and this is related to higher mortality. It is necessary to optimize care strategies during every neonatal transfer. INTRODUCCIÓNEl traslado neonatal adecuado es un componente clave del cuidado del recién nacido (RN) enfermo que requiere derivación a centros de mayor complejidad. Cuando un...

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Section: Discussionunclassified

Factores de riesgo asociados a deterioro clínico en el traslado de recién nacidos enfermos

et al. 2012

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“…This was used to evaluate the effects of neonatal transport conditions on the mortality rate in NICU (especially, in the first seven days of hospitalization) (10). Scoring system is shown in Table 1.…”

Section: Transport Risk Index Of Physiologic Stability (Trips)mentioning

confidence: 99%

Diyarbakır’da hasta yenidoğanın taşınması konusunda yapılan iyileştirme çalışmaları ve bebeklere yansımaları

Uslu¹,

Aldudak²,

Özdemir³

2011

tpa

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“…An infant was defined as small for gestational age if the birth weight was less than the third percentile for GA according to the published data for Canadian infants. 16 Clinical Risk Index for Babies (CRIB) score, 17 Score of Acute Neonatal Physiology, version IIFPhysiologic Extension 18 and Transport Risk Index of Physiologic Stability (TRIPS) 19 are neonatal illness severity scores calculated from variables during the first day of admission to the NICU. PPHN was defined as persistent labile hypoxemia (PaO 2 <50 in 100% oxygen) in the absence of structural cardiovascular malformation disproportionate to the degree of pulmonary parenchymal disease and associated with clinical (PaO 2 difference of >15 mm Hg between pre-and postductal values) or echocardiographic evidence of right to left shunting at atrial and/or ductal level, tricuspid regurgitation and elevated right ventricular systolic pressure.…”

Section: Definitions For Outcomesmentioning

confidence: 99%

Rupture of membranes before the age of viability and birth after the age of viability: comparison of outcomes in a matched cohort study

et al. 2010

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Objective: To compare composite adverse outcome rate of infants <32 weeks gestational age (GA) who were born after preterm premature rupture of membranes (PPROM) at previable gestation to those born without PPROM.Study Design: Retrospective review of prospective collected data for infants discharged between 2004 and 2007 was conducted. Cases were infants with >7 days of PPROM that occurred before 24 weeks. Matched cohort consisted of infants born without PPROM (matched for GA, sex and admission date). Composite adverse outcome was assessed considering death or any of the following three severe morbidities (severe neurological injury, severe retinopathy of prematurity or chronic lung disease).Result: The 29 cases had higher mean severity of illness score compared with 74 matched infants. Mean duration of ROM was 45 vs 2 days and mean GA at the ROM was 21 vs 27 weeks, respectively. Logistic regression confirmed significantly higher risk of composite adverse outcome rates for cases (69 vs 47%; P ¼ 0.02, adjusted odds ratio 4.0, 95% CI 1.2, 13.6). Conclusion:The survival rate for infants born at <32 weeks following PPROM at previable age has improved significantly; however, these infants had a higher rate of adverse composite neonatal outcome.

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Transport risk index of physiologic stability: A practical system for assessing infant transport care

Cited by 132 publications

References 16 publications

Factores de riesgo asociados a deterioro clínico en el traslado de recién nacidos enfermos

Factores de riesgo asociados a deterioro clínico en el traslado de recién nacidos enfermos

Diyarbakır’da hasta yenidoğanın taşınması konusunda yapılan iyileştirme çalışmaları ve bebeklere yansımaları

Rupture of membranes before the age of viability and birth after the age of viability: comparison of outcomes in a matched cohort study

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