Search

We aim to evaluate clinical outcomes of emergent extracorporeal membrane oxygenation (ECMO) implantation in newborns with life-threatening meconium aspiration syndrome (MAS) in peripheral hospitals with Hub and Spoke (HandS) setting. We retrospectively reviewed all neonates presenting with MAS, with no other comorbidities, treated with HandS ECMO, in peripheral hospitals. Team activation time (TAT) was described as the time from first alerting call to ECMO support initiation. From May 2014 to December 2016, 4 patients met our inclusion criteria. In addition, 2 cases occurred on the same day, requiring a second simultaneous HandS ECMO team activation. All patients were younger than 8 days of life (1, 1, 4, and 7), with a mean BSA 0.21 ± 0.03m

Late preterm (LP) infants need more frequently neonatal resuscitation and have a higher incidence of postnatal problems than full term infants. The majority of LP infants born at level I and II hospitals. Aim The objectives of the present study were: i) to measure the risk of postnatal transfer of LP infants born at level I and II hospitals; ii) to compare the main neonatal outcomes (mortality, respiratory disease, neurological outcomes, etc…) and care (need for specific procedures and lenght of hospital stay) between outborn LP and inborn LP infants; iii) to assess whether the place of birth (level I, II, III) may influence neonatal outcomes in this population. Materials and Methods Data of all LP infants born at the 25 hospitals of Veneto Orintale area between January, 1, 2003 and December, 31, 2013 were obtained from the following sources: certificate of delivery care (CEDAP), hospital dicharge records (SDO) and records and register of the Regional Neonatal Transport Service. Results During the study period, 279.865 neonates were born in the area; of these 15.525 (5,5%) were LP infants, who account for 72,2% of all preterm births. Totally, 1621 (0,57%) neonates needed postnatal transfer; of these 19,4% were LP infants. In comparison to the full term infants, LP infants had a higher risk of postnatal transfer: RR 7,43 (95%CI 6,51-8,47). The risk of perinatal asphyxia (RR 3,70; 95%CI % 1,78-7,71), respiratory distress (RR 1,23; 95%CI 1,15-1,32) and pneumothorax (RR 2,85; 95%CI 1,78-4,52) was significantly higher in outborn than inborn LP infants. Outborn LP infants needed more frequently mechanical ventilation (RR 1,70; 95%CI 1,34-2,16) and chest drain (RR 2,05; 95%CI 1,02-4,09) than inborn LP. Their hospital stay was 7 significantly longer than inborn LP infants: 11 days (IQR 7-8) vs. 7 days (IQR 4-16). In addition to biological parameters (male, 34 and 35 weeks gestation, birth weight