Rathod Deepak, Adhisivam B, Bhat B Vishnu
Junior Resident, Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Associate Professor, Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Trop Doct. 2015 Apr;45(2):96-9. doi: 10.1177/0049475514564270. Epub 2014 Dec 22.
To describe the transport of sick neonates to a tertiary care hospital and evaluate their condition at arrival and outcome.
This descriptive study included 303 extramural neonates who were transported to a tertiary care hospital in south India. Demographic parameters, transport details and clinical features at arrival were recorded. All neonates were followed up till discharge or death. Transport and clinical variables were correlated with outcome.
Sepsis and birth asphyxia were the major indications for transport. Only 11% were transported by 108 ambulances (free government service). One-fifth of all neonates died and among them 76% were hypothermic and 10% hypoglycemic on admission. Prematurity, pregnancy induced hypertension (PIH), prolonged rupture of membranes (PROM), respiratory distress, grunting, bleeding, abdominal distension and a positive blood culture correlated with a poor outcome.
Stabilisation prior to transport is essential and the principles of neonatal transportation are independent of distance. Hypothermia and hypoglycaemia should be prevented in neonates during transport as they adversely affect the outcome.
描述患病新生儿转运至三级医院的情况，并评估其到达时的状况及预后。
这项描述性研究纳入了303名被转运至印度南部一家三级医院的院外新生儿。记录了人口统计学参数、转运细节及到达时的临床特征。所有新生儿均随访至出院或死亡。将转运和临床变量与预后进行关联分析。
脓毒症和出生窒息是转运的主要指征。仅11%由108急救车（免费政府服务）转运。所有新生儿中有五分之一死亡，其中76%入院时体温过低，10%血糖过低。早产、妊娠高血压综合征（PIH）、胎膜早破（PROM）、呼吸窘迫、呻吟、出血、腹胀及血培养阳性与不良预后相关。
转运前的稳定处理至关重要，新生儿转运原则与距离无关。转运期间应预防新生儿体温过低和血糖过低，因为它们会对预后产生不利影响。
