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Trends in neonatal emergency transport in the last two decades
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media Deutschland GmbH, 2021.
-
Abstract
- Although maternal antenatal transfer is the preferred option, some infants inevitably need urgent transport to a tertiary neonatal care facility after birth. This study aimed to investigate trends over time in patient characteristics and respiratory management in a large series of neonatal emergency transfers, in order to provide health caregivers an up-to-date profile of such patients and their therapeutic needs. Trends in patient characteristics and respiratory management were evaluated in 3337 transfers by the Eastern Veneto Neonatal Emergency Transport Service in 2000–2019. Joinpoint regression analysis was performed to evaluate trends and to estimate annual percentage changes (APCs). Proportions of preterm neonates increased (APC2000–2012 2.25%), then decreased (APC2012–2019 − 6.04%). Transfers at birth increased (APC2000–2013 2.69%), then decreased (APC2013–2019 − 5.76%). Proportion of neonates with cardiac and surgical diseases declined (APCs2000–2019 − 6.82% and − 3.32%), while proportion of neonates with neurologic diseases increased (APC2000–2019 8.62%). Use of nasal-continuous-positive-airway-pressure (APC2000–2019 9.72%) and high-flow-nasal-cannula (APC2007–2019 58.51%) at call, and nasal-continuous-positive-airway-pressure (APC2000–2019 13.87%) and nasal-intermittent-mandatory-ventilation (APC2000–2019 32.46%) during transfer increased. Mechanical ventilation during transfer decreased (APC2014–2019 − 10.77%). Use of oxygen concentrations at 21% increased at call and during transfer (APCs 2000–2019 2.24% and 2.44%), while oxygen concentrations above 40% decreased at call and during transfer (APCs 2000–2019 − 3.93% and − 5.12%). Conclusion: Our findings revealed a shift toward a more “gentle” approach and the reduced use of oxygen in respiratory management. Equipment and team expertise should meet the requirements of such changing patients and their therapeutic needs.
- Subjects :
- medicine.medical_specialty
Joinpoint regression
medicine.medical_treatment
Transport
Intermittent Positive-Pressure Ventilation
03 medical and health sciences
0302 clinical medicine
Neonate
Pregnancy
030225 pediatrics
medicine
Respiratory management
Trend
Humans
In patient
030212 general & internal medicine
Respiratory system
Mechanical ventilation
Respiratory Distress Syndrome, Newborn
Emergency transport
Continuous Positive Airway Pressure
business.industry
Infant, Newborn
Infant
Large series
Respiration, Artificial
Care facility
Pediatrics, Perinatology and Child Health
Emergency medicine
Female
business
Infant, Premature
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....d05255b93b63113524485c98a615adc6