Document Detail


Use of nasal continuous positive airway pressure during retrieval of neonates with acute respiratory distress.
MedLine Citation:
PMID:  18346987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although nasal continuous positive airway pressure is widely used in neonatal units, its use in neonatal transport is not yet established. Previous reports have been limited to small numbers of primary road transports and larger numbers of return transports while its use in air transportation has not been reported. The aim of this study was to assess the safety and effectiveness of transporting neonates and infants by road or air while treated with nasal continuous positive airway pressure. METHODS: We conducted a retrospective review of the records of all infants transported between January 1, 2004, and November 1, 2005. RESULTS: A total of 220 infants were treated with nasal continuous positive airway pressure; of these, 13 infants (6%) were intubated before transport, leaving 207 infants transported on a median nasal continuous positive airway pressure of 7 cm H(2)O. Thirty infants were transported by fixed or rotary wing aircraft and 190 by road. No infants required intubation or bag and mask ventilation during transport. Twenty-eight infants (13%) required intubation within 24 hours of arrival at the receiving hospital, 4 infants (2%) were intubated > 24 hours after arrival, 11 infants (5%) were intubated for surgery, and 164 infants (73%) were never intubated. A total of 111 infants (50%) were preterm and < 72 hours old at transport, and 32 infants (15%) were < or = 32 weeks' gestational age and < 72 hours old at transport. Fraction of inspired oxygen was significantly lower at the end of transport (0.45 vs 0.34). CONCLUSIONS: Nasal continuous positive airway pressure is effective and has an acceptable safety margin for the road-based transportation of infants with acute respiratory distress. Air transport is feasible but larger studies are required to assess safety.
Authors:
Philip G Murray; Michael J Stewart
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Publication Detail:
Type:  Journal Article     Date:  2008-03-17
Journal Detail:
Title:  Pediatrics     Volume:  121     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-02     Completed Date:  2008-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e754-8     Citation Subset:  AIM; IM    
Affiliation:
Newborn Emergency Transport Service, Royal Women's Hospital, Carlton, Victoria, Australia. Philip.Murray@manchester.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Blood Gas Analysis
Cohort Studies
Confidence Intervals
Continuous Positive Airway Pressure / methods*
Female
Follow-Up Studies
Gestational Age
Humans
Infant, Newborn
Infant, Premature*
Male
Probability
Respiratory Distress Syndrome, Newborn / diagnosis,  mortality,  therapy*
Retrospective Studies
Risk Assessment
Safety
Severity of Illness Index
Statistics, Nonparametric
Survival Analysis
Transportation of Patients / methods*
Treatment Outcome
Ventilator Weaning

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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