Safety, speed, and effectiveness of air transportation for neonates
| Autor: | Yoshiki Naito, Masato Kamitomo, Chie Ishihara, Yuta Mikami, Hiroshi Ohashi, Tomonori Kurimoto, Satoshi Ibara, Tatsu Takayama, Yuichi Kodaira, Masakatsu Yamamoto, Tsuyoshi Yamamoto, Masaya Kibe, Hideaki Yoshihara, Eiji Hirakawa |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ambulances Gestational Age 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Pregnancy law 030225 pediatrics Intensive care medicine Birth Weight Humans Cerebral Hemorrhage business.industry Infant Newborn Infant Gestational age medicine.disease Intensive care unit Confidence interval Transportation of Patients Intraventricular hemorrhage Respiratory failure Pediatrics Perinatology and Child Health Emergency medicine Apgar Score Female Apgar score business First aid |
| Zdroj: | Pediatrics International. 63:415-422 |
| ISSN: | 1442-200X 1328-8067 |
| Popis: | BACKGROUND In Japan, 44.3% of neonates are delivered in private clinics without an attending pediatrician. Obstetricians in the clinics must resuscitate asphyxiated neonates in unstable condition, such as respiratory failure, and they are frequently transferred to tertiary perinatal medical centers. There has been no study comparing the physiological status and prognosis of neonates transported by ambulance with those transported by helicopter. METHODS Medical and transport records were used to compare the physiological status of neonates transported to Kagoshima City Hospital by land and those transported by air between January 1, 2013, and December 31, 2017. RESULTS Data from 425 neonates transferred by land and 143 by air were analyzed. There were no significant differences between the two groups in mean gestational age, mean birthweight, fetal blood pH, Apgar score, or the Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II) on arrival to the tertiary center (16.3 ± 15.4 [95% confidence interval (CI): 13.2-17.7] vs 16.4 ± 15.4 [95% CI: 13.9-19.0], respectively; P = 0.999); both groups had SNAPPE-II score 10-19, indicating no difference in mortality risk. The times to starting first aid and to admission to the intensive care unit were significantly reduced in neonates transported by air than by land. In subgroup analysis of patients of a gestational age ≤28 weeks, all cases of severe intraventricular hemorrhage (IVH) were observed in the land transportation group. CONCLUSIONS Neonatal transportation by air is as safe as land transportation, and time to first aid and intensive care are significantly reduced by transportation by air than by land. Air transport could also contribute to the prevention of IVH in neonatal transportation. |
| Databáze: | OpenAIRE |
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