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Procedural Interventions and Stabilization Times During Interfacility Neonatal Transport.

Aravanan Anbu Chakkarapani1, Hilary E Whyte2, Edith Massé3

  • 1Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neonatology, Sidra Medicine, Doha, Qatar, United Arab Emirates; Department of Pediatrics, Weill Cornell Medicine, Doha, Qatar, United Arab Emirates.

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Transport teams performing interventions on critically ill neonates can impact stabilization time. Minimizing nonessential procedures, like umbilical arterial catheter insertion, may improve timely transfer to tertiary centers.

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Area of Science:

  • Neonatal care
  • Transport medicine
  • Medical procedures

Background:

  • Interfacility neonatal transports involve critical care teams performing procedural interventions.
  • Stabilization at nontertiary centers is a crucial step before transfer.

Purpose of the Study:

  • To analyze the impact of procedural interventions on stabilization time during neonatal transports.
  • To identify factors influencing stabilization duration in critically ill neonates.

Main Methods:

  • Retrospective cohort study using the Canadian Neonatal Transport Network database (2014-2016).
  • Analysis of demographics and procedures in 3,350 neonatal transports.
  • Multivariable logistic regression to evaluate predictors of stabilization time.

Main Results:

  • Peripheral intravenous insertion, arterial blood gas sampling, and endotracheal tube insertion were most frequent.
  • Success rates varied, with lower rates for umbilical arterial catheter insertions.
  • More invasive procedures and higher intervention numbers correlated with longer stabilization times.

Conclusions:

  • The type and frequency of procedures significantly affect neonatal transport stabilization time.
  • Minimizing nonessential procedures, such as umbilical arterial catheter insertion, can expedite transfer to tertiary centers.
  • Variations in procedural success highlight opportunities for benchmarking and sharing best practices.