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A twelve-year neonatal and pediatric high-frequency oscillatory ventilation transport experience

Jean-Eudes Piloquet1, Mathieu Genuini2,3, Katia Kessous2

  • 1Neonatal and Pediatric Intensive Care Unit, Hôpital Trousseau, AP-HP, Université Pierre et Marie Curie, Paris, France.

Pediatric Pulmonology
|December 22, 2020
PubMed

Insights

Pediatric intensive care unit transport teams can safely transport neonates and children on high-frequency oscillation ventilation (HFOV). While challenges exist, survival rates improved, and extracorporeal membrane oxygenation (ECMO) use decreased over 12 years.

Area of Science:

  • Pediatric Critical Care Medicine
  • Transport Medicine
  • Respiratory Support

Background:

  • Interhospital transport of critically ill pediatric and neonatal patients presents unique challenges, particularly when requiring advanced respiratory support like high-frequency oscillation ventilation (HFOV).
  • Optimizing transport protocols is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To evaluate the 12-year evolution of a pediatric intensive care unit transport team's (PICU-TT) experience with interhospital transportation of pediatric and neonatal patients on HFOV.
  • To assess the safety, efficacy, and outcomes associated with HFOV transport over time.

Main Methods:

  • A monocentric retrospective observational study was conducted from January 2006 to December 2017.
  • Included were all patients under 18 years old transported on HFOV by the Robert Debré Hospital PICU-TT.
  • Data collected included patient demographics, HFOV parameters, adverse events, and survival rates.

Main Results:

  • A total of 125 patients (107 neonates, 18 children) were transported on HFOV.
  • Adverse events occurred in 22% of transports, with a 74% overall survival rate at discharge.
  • Over the last four years, HFOV transport rates increased for neonates, ECMO initiation decreased, and survival rates significantly improved (p < .05).

Conclusions:

  • HFOV transportation by a PICU-TT is feasible, despite inherent challenges.
  • A trend towards utilizing extracorporeal membrane oxygenation (ECMO) for the most severe cases was observed.
  • Increased HFOV transport rates for less severe neonatal patients suggest evolving management strategies.
Abstract

Keywords:
critical carehigh-frequency ventilationinfantnewborntransportation of patients

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