Preserved inflammatory homeostasis during emergency transport: a multibiomarker assessment of neonatal RDS transfers

The aim was to compare the pre- and posttransport levels of systemic inflammatory markers in neonatal infants transported to a tertiary intensive care unit via emergency health services with a neonatal respiratory distress syndrome (nRDS) diagnosis and to assess the quality of transport.

This retrospective study was conducted between January 2019 and December 2023. A total of 117 nRDS patients' emergency transports were included in the study. Demographic data, transfer time, intubation, cold treatment, cardiopulmonary resuscitation (CPR), and pre- and posttransport laboratory parameters were obtained retrospectively. The statistical analysis was performed using IBM SPSS Statistics (Version 22.0), with a significance level of p < 0.05.

The mean gestational age at birth was 35.46 ± 4.189 weeks. Among the neonates transported, 41.9% (n = 49) were intubated and 41.9% (n = 49) required mechanical ventilation during transport. CPR was performed in 12.8% (n = 15) of cases, with 4.3% (n = 5) requiring prolonged CPR. The mortality rate was 11.1% (n = 13). The mean neutrophil-to-lymphocyte ratio (NLR) was 3.0 ± 3.40, the platelet-to-lymphocyte ratio (PLR) was 101.2 ± 103.9, the systemic inflammatory index (SII) (×10³) was 1.91 ± 2.43, and the haemoglobin, albumin, lymphocyte, platelet (HALP) score was 10.42 ± 21.36. No statistically significant differences were observed between the pre- and posttransfer values of the NLR, PLR, HALP index, or SII (overall p > 0.05).

No significant differences were detected between pre- and posttransport inflammatory marker levels. These findings suggest that the transport process may not be associated with a measurable inflammatory response, possibly reflecting the effectiveness of appropriate treatment and stabilisation during transport.