scholarly journals Evaluation of Neonatal Transport in Western Switzerland: A Model of Perinatal Regionalization

2017 ◽  
Vol 11 ◽  
pp. 117955651770902 ◽  
Author(s):  
Caitriona Gilleece McEvoy ◽  
Emilienne Descloux ◽  
Mirjam Schuler Barazzoni ◽  
Corinne Stadelmann Diaw ◽  
Jean-François Tolsa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Retrospective Analysis ◽  
Neonatal Intensive Care ◽  
Time Frame ◽  
Transport Activity ◽  
Know How ◽  
Neonatal Transport ◽  
Perinatal Network ◽  
Transport Team ◽  
Perinatal Regionalization

Neonatal transport is an essential part of regionalization for highly specialized neonatal intensive care. This retrospective analysis of prospectively collected data on neonatal transport activity in a large Swiss perinatal network more than 1 year, aimed to quantify this activity, to identify the needs for staff, and the demands regarding know-how and equipment. Of the 565 admissions to the tertiary neonatology clinic, 176 (31.2%) were outborn patients, transported as emergencies to the level III unit. In 71.6% of cases, respiratory insufficiency was one of the reasons for transfer. Circadian and weekly distribution showed increased transport activity on workdays between 8 am and 10 pm, but regular demands for emergency transports regardless of the time frame require a neonatal transport team available 24/7. This study highlights the importance of neonatal transport and unveils several functional and infrastructural insufficiencies, which led to suggestions for improvement.

Control of Oxygenation during the Transport of Sick Neonates

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 117-119
Author(s):  
Carol Miller ◽  
Ronald I. Clyman ◽  
Robert S. Roth ◽  
Susan H. Sniderman ◽  
Roberta A. Ballard ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Transport System ◽  
Perinatal Care ◽  
Acid Base ◽  
Neonatal Transport ◽  
Transport Team ◽  
Acid Base Status ◽  
Preliminary Study ◽  
Newborn Intensive Care

A safe neonatal transport system is an essential component in the regionalization of perinatal care. Despite efforts to provide continuous intensive care to sick infants during transport,1-5 several studies have revealed an increased morbidity and mortality among infants transported to newborn intensive care units (NICU) compared with those infants born at the NICU.6,7 There is little information available about the adequacy of monitoring and maintaining oxygenation and acid-base status during infant transport. In a preliminary study we examined the ability of a neonatal transport team to maintain an infant's Pao2 (46 to 100 torr), pH (7.25 to 7.55), and Paco2 (20 to 50 torr) in the "physiologic" range during transport.

A retrospective analysis of the clinical effectiveness of subcutaneously tunneled femoral vein cannulations at the bedside: A low risk central venous access approach in the neonatal intensive care unit

2020 ◽  
pp. 112972982096929
Author(s):  
Matthew Ostroff ◽  
Adel Zauk ◽  
Sara Chowdhury ◽  
Nancy Moureau ◽  
Carly Mobley
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Retrospective Analysis ◽  
Neonatal Intensive Care ◽  
Femoral Vein ◽  
Central Venous Access ◽  
Venous Access ◽  
Right Atrial ◽  
Central Venous

Objective: The purpose of this retrospective analysis was to evaluate the clinical efficacy and safety of ultrasound (US)-guided, subcutaneously tunneled, femoral inserted central catheters (ST-FICCs) in the neonatal intensive care unit (NICU). Methods: Following clinical success with ST-FICCs in adults, we expanded this practice to the neonatal population. In an 18-month retrospective cohort analysis (2018–2020) of 82 neonates, we evaluated the clinical outcome for procedural success, completion of therapy, and incidence of early and late complications for insertion of US-guided ST-FICCs in the NICU. Results: Placement of ST-FICCs were successful in 100% of neonates ( n = 82/82) with 94% to the right ( n = 77/82) and 6% to the left common femoral veins ( n = 5/82). Gestational age ranged 23-39 weeks with median age of 29 weeks. Birthweight ranged from 450 g to >2000 g. Weight at insertion ranged 570 to 3345 g and day of life 1 to 137, with median at day 5. Ultrasound guided femoral vein puncture was recorded on 74 patients, first attempt 63/74 (85%), second attempt 8/74 (11%) and third attempt 3/74 (4%). Catheter french used: 1.9Fr ( n = 80/82), 2.6Fr ( n = 1/82), and 3-Fr ( n = 1/82). Catheter lengths were 8 to 20 cm, average 12cm. Catheter termination confirmed with posterior/anterior and lateral abdominal radiographs with inferior vena cava (IVC) ( n = 33/82), IVC/right atrial junction ( n = 31/82), or right atrium ( n = 18/82). Atrial placements were retracted; no cases of malposition to the lumbar/renal/hepatic veins ( n = 0/82). 1528 catheter days ranging 5 to 72 days (average 18). No insertion-related or post-insertion complications. All patients completed prescribed therapy with one catheter. Conclusion: Bedside placement of an ST-FICC is a safe route for central venous access in the NICU, preserving upper extremity vasculature, eliminates risks associated with sedation, fluoroscopy, tunneled and non-tunneled supra-diaphragmatic central venous insertion.

Improving Perinatal Regionalization by Predicting Neonatal Intensive Care Requirements of Preterm Infants: An EPIPAGE-Based Cohort Study

PEDIATRICS ◽  
2006 ◽  
Vol 118 (1) ◽  
pp. 84-90 ◽  
Author(s):  
R. Vieux ◽  
J. Fresson ◽  
J.-M. Hascoet ◽  
B. Blondel ◽  
P. Truffert ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Perinatal Regionalization ◽  
Care Requirements

scholarly journals Bedside Neonatal Intensive Care Unit Surgery- Myth or Reality!

2013 ◽  
Vol 2 (2) ◽  
pp. 20 ◽  
Author(s):  
Shandip Kumar Sinha ◽  
Sujoy Neogi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Emergency Surgery ◽  
Neonatal Intensive Care ◽  
Surgical Team ◽  
Neonatal Transport ◽  
Novel Concept

Neonatal transport is associated with complications, more so in sick and unstable neonates who need immediate emergency surgery. To circumvent these problems, surgery in Neonatal intensive care unit (NICU) is proposed for these neonates. This article reviews the literature regarding feasibility of this novel concept and based on the generated evidence, suggest the NICU planners to always include infrastructure for this. Also neonatal surgical team can be developed that could be transported.

An Analysis of Air Transport Results in the Sick Newborn Infant: Part I. The Transport Team

PEDIATRICS ◽  
1975 ◽  
Vol 55 (6) ◽  
pp. 774-782
Author(s):  
Gary Pettett ◽  
Gerald B. Merenstein ◽  
Frederick C. Battaglia ◽  
L. Joseph Butterfield ◽  
Ruth Efird
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Emergency Care ◽  
Neonatal Intensive Care ◽  
Air Transport ◽  
Care Nurse ◽  
Sick Newborn ◽  
Transport Team ◽  
Newborn Intensive Care ◽  
Intensive Care Nurse

Regionalization of neonatal intensive care has necessitated air transport of the critically ill infant in sparsely populated areas. All newborn air transports to four Denver area newborn intensive-care units over a 14-month period were reviewed. An emergency-care nurse and a neonatal intensive-care nurse provided the basic transport team with physician assistance in selected cases. Infants were evaluated and stabilized at the referring hospital before moving the infant. The transports were analyzed for the type of aircraft utilized, reason for referral, and mortality. The results indicate that prior planning will permit the use of the most appropriate aircraft and transport team. When using well-trained transport personnel, the presence of a physician may be limited to specific situations without adversely affecting overall neonatal mortality.

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