Delacrétaz Romaine, Fischer Fumeaux Céline J, Stadelmann Corinne, Rodriguez Trejo Adriana, Destaillats Alice, Giannoni Eric
Department of Pediatrics, eHnv Yverdon-les-Bains, Yverdon-les-Bains, Switzerland; Department Mother-Woman-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Department Mother-Woman-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
J Pediatr. 2022 Jan;240:44-50. doi: 10.1016/j.jpeds.2021.08.074. Epub 2021 Sep 1.
To determine the frequency, type, and severity of adverse events (AEs) during intrahospital transport of newborn infants and to identify associated factors.
We conducted a prospective observational study in a tertiary care academic neonatal unit. All patients hospitalized in the neonatal unit and undergoing intrahospital transport between June 1, 2015, and May 31, 2017 were included. Transports from other hospitals and the delivery room were not included.
Data from 990 intrahospital transports performed in 293 newborn infants were analyzed. The median postnatal age at transport was 13 days (Q1-Q3, 5-44). Adverse events occurred in 25% of transports (248/990) and were mainly related to instability of cardiovascular and respiratory systems, agitation, and temperature control. Adverse events were associated with no harm in 207 transports (207/990, 21%), mild harm in 37 transports (37/990, 4%), and moderate harm in 4 transports (4/990, 0.4%). There was no severe or lethal adverse event. Hemodynamic support with catecholamines, the presence of a central venous catheter, and a longer duration of transport were independent predictors for the occurrence of adverse events during transport.
Intrahospital transports of newborns are associated with a substantial proportion of adverse events of low-to-moderate severity. Our data have implications to inform clinical practice, for benchmarking and quality improvement initiatives, and for the development of specific guidelines.
确定新生儿院内转运期间不良事件(AE)的发生频率、类型和严重程度,并识别相关因素。
我们在一家三级医疗学术新生儿病房进行了一项前瞻性观察研究。纳入了2015年6月1日至2017年5月31日期间在新生儿病房住院并接受院内转运的所有患者。不包括从其他医院和产房的转运。
分析了293例新生儿进行的990次院内转运的数据。转运时的出生后中位年龄为13天(四分位间距,5 - 44天)。25%的转运(248/990)发生了不良事件,主要与心血管和呼吸系统不稳定、躁动及体温控制有关。207次转运(207/990,21%)的不良事件无危害,37次转运(37/990,4%)有轻度危害,4次转运(4/990,0.4%)有中度危害。没有严重或致命的不良事件。使用儿茶酚胺进行血流动力学支持、存在中心静脉导管以及较长的转运时间是转运期间不良事件发生的独立预测因素。
新生儿院内转运与相当比例的低至中度严重程度的不良事件相关。我们的数据对指导临床实践、进行基准对比和质量改进举措以及制定具体指南具有意义。