Newborn Care Unit, John Radcliffe Hospital, Oxford, UK.
Paediatric Infant and Perinatal Retrieval Service (PIPER), The Royal Children's Hospital, Melbourne, VIC, Australia.
J Perinatol. 2020 Oct;40(10):1570-1575. doi: 10.1038/s41372-020-0679-0. Epub 2020 May 11.
To assess the effect of reducing retrieval team response time on the outcomes of babies born outside a cardiac centre (outborn) with antenatally diagnosed transposition of the great arteries.
Retrospective cohort study of all outborn babies with antenatally diagnosed TGA anticipated to require transfer for urgent balloon atrial septostomy over a 6-year period (15 babies pre intervention and 27 post intervention). The intervention involved a collaborative multicomponent practice change aiming to reduce retrieval team response time.
The mean (SD) time from birth to cardiac ICU arrival was 159 (12) min pre intervention and 103 (6) min post intervention (mean difference -57 min [95% CI, -81 to -32]). There was a significant decrease in need for extracorporeal membrane oxygenation (33% versus 4%), RR 0.11 [95% CI, 0.02-0.65]), with a number needed to treat of 3.4 to prevent one ECMO episode.
Reducing retrieval time is achievable with collaborative systems, and significantly improves clinical outcomes.
评估减少检索团队响应时间对心脏中心外出生（outborn）的产前诊断为大动脉转位婴儿结局的影响。
对 6 年来所有产前诊断为 TGA 且预计需要紧急球囊房间隔造口术转院的 outborn 婴儿进行回顾性队列研究（干预前 15 例，干预后 27 例）。干预措施包括旨在减少检索团队响应时间的协作多组分实践改变。
干预前从出生到心脏 ICU 到达的平均（SD）时间为 159（12）min，干预后为 103（6）min（平均差异-57 min [95%CI，-81 至-32]）。需要体外膜氧合（ECMO）的比例显著降低（33% 对 4%），RR 0.11 [95%CI，0.02-0.65]），预防 1 例 ECMO 发生的治疗需要数为 3.4。
通过协作系统可以实现检索时间的减少，并且显著改善临床结果。
