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Structure of causes of non-transportability of newborns

https://doi.org/10.24884/2072-6716-2022-23-2-31-37

Abstract

Purpose: to analyze the structure of the reasons for non-transportability during pretransport therapy of newborns and its relationship with the outcomes of the hospital stage.

Materials and methods. А cohort study of 604 cases of a transport team visits for 564 newborn hospitalized in medical organizations of the Sverdlovsk region. In the studied sample, according to the tactical decision of the transport team, subgroups of transportable (n=497) and non-transportable patients (n=46) were identified. Anamnesis data, the structure of the causes of non-transportability, and the outcomes of the hospital stage were analyzed.

Results. Тhe main causes of non-transportability were respiratory failure (86.96%) and circulatory failure (43.48%), in 50% of cases a combination of two or more reasons was observed. The presence of two causes of non-transportability significantly increases the risk of death (RR=4.09 [2.01–8.32]) and 7-day mortality (RR=5.14 [1.78–14.85]). The combination of circulatory failure and respiratory failure significantly increases the risk of death (RR=7.76 [4.39–13.71]) and 7-day mortality (RR=12.2 [5.12–29.08]).

Conclusion. Respiratory failure and circulatory failure predominate in the structure of the reasons for the non-transportability of newborns. The greatest growth of total and 7-day mortality is observed with a combination of respiratory failure and circulatory failure.

About the Authors

R. F. Mukhametshin
Ural State Medical University; Regional Children’s hospital
Russian Federation

 Yekaterinburg 



N. S. Davidova
Ural State Medical University
Russian Federation

 Yekaterinburg 



References

1. American Academy of Pediatrics Committee on Fetus And Newborn. Levels of neonatal care // Pediatrics. 2012. Vol. 130, No. 3. Р. 587–597. doi: 10.1542/peds.2012–1999.

2. Insoft R.M., Schwartz H. P. American Academy of Pediatrics. Section on transport medicine. Equipment and medications // Guidelines for air and ground trans port of neonatal and pediatric patients. 4rd ed. Elk Grove Village, IL: American Academy of Pediatrics. 2015. 488 р.

3. Wynn J.L., Kelly M. S., Benjamin D. K., Clark R. H., Greenberg R., Benjamin D. K. Jr, Smith P. B. Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis // Am. J. Perinatol. 2017. Jun. Vol. 34, № 7. р.633–639. doi: 10.1055/s-0036.159.7130.

4. Wynn J.L., Polin R. A. A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants // Pediatr. Res. 2020. Vol. 88, No. 1. Р. 85–90. doi: 10.1038/s41390.019.0517–2.

5. Aleksandrovich Yu.S., Pshenisnov K. V., Cherevatenko R. I., Kopylov V. V., Andreev V. V., Parshin E. V. Features of intensive care for children at transhospital transportation. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, 2011, No. 3, рр. 9–15 (In Russ.).

6. Aleksandrovich Yu. S., Nurmagamhetova B. K., Pshenisnov K. V., Parshin Ye. V., Gordeyev V. I. Multiple organ dysfunctions in the newborn. Anesthesiology and Intensive Care, 2008, No. 1, рр. 11–14 (In Russ.).

7. Aleksandrovich Yu. S., Nurmagambetova B. K., Pshenisnov K. V., Parshin E. V. Specific features of the course of multiple organ dysfunction syndrome in the full-term and premature neonate. Clinical Practice in Pediatrics, 2009, Vol. 4, No. 1, pр. 19–21 (In Russ.).

8. Narli N., Kirimi E., Uslu S. Turkish Neonatal Society guideline on the safe transport of newborn // Turk. Pediatri Ars. 2018. Vol. 25, No. 53. Р. 18–31. doi: 10.5152/TurkPediatriArs.2018.01804.

9. Odetola F. O., Gebremariam A. Transfer hospitalizations for pediatric severe sepsis or septic shock: resource use and outcomes // BMC Pediatr. 2019. Vol. 19, No. 1. Р. 196. doi: 10.1186/s12887.019.1577–5.

10. Shmakov A. N., Kokhno V. N. Critical conditions of newborns (remote counseling and evacuation technology). Novosibirsk: IPK BIONT, 2007. 168 р. (In Russ.).

11. Bushtyrev V. A., Budnik V. A., Kuznetsova N. B. Criteria for the transportability of premature newborns. Оbstetrics and gynecology, 2015, No. 7, pр. 74–77 (In Russ.).

12. Aleksandrovich Yu. S., Nurmagambetova B. K., Pshenisnov K. V., Parshin E. V. Prognostication of early outcomes of multiple organ dysfunction in neonates. Siberian Scientific Medical Journal, 2010, Vol. 95, No. 4, pр. 65–69 (In Russ.).

13. Alexandrovich Y. C., Pshenisov K. B., Parshin E. V., Nurmagambetova B. K., Cherevatenco R. I. Hospital-to-hospital transportation of the newborns with multiple organ insufficiency. Emergency medical care, 2009, Vol. 10, No. 1, рp. 9–13 (In Russ.).

14. Akexandrovich Yr.S., Pshenisnov K. V., Parshin E. V., Nurmagambetova В. K. Predictors of multisystem organ failure at the newborns requiring interhospital transportation. Emergency medical care, 2008, Vol. 9, No. 4, рр. 29–34 (In Russ.).

15. Proulx F., Joyal J. S., Mariscalco M. M., Leteurtre S., Leclerc F., Lacroix J. The pediatric multiple organ dysfunction syndrome // Pediatr. Critical Care Medicine. 2009. Vol. 10, No. 1. Р. 12–22.

16. Hooper S.B., Te Pas A. B., Lang J., van Vonderen J. J., Roehr C. C., Kluckow M., Gill A. W., Wallace E. M., Polglase G. R. Cardiovascular transition at birth: a physiological sequence // Pediatr. Res. 2015. No. 77. Р. 608–614. doi: 10.1038/pr.2015.21.

17. Sweet D.G., Carnielli V., Greisen G., Hallman M., Ozek E., Te Pas A., Plavka R., 0Roehr C.C., Saugstad O. D., Simeoni U., Speer C. P., Vento M., Visser G. H.A., Halliday H. L. European Consensus Guidelines on the Management of Respiratory Distress Syndrome — 2019 Update // Neonatology. 2019. Vol. 115, No. 4. Р. 432–450. doi: 10.1159/000499361.

18. Van Vonderen J. J., Roest A. A.W., Klumper F. J.C., Hooper S. B., Te Pas A. B. The effect of breathing on ductus arteriosus blood flow directly after birth // Eur. J. Pediatr. 2017. Vol. 176, No. 12. Р. 1581–1585. doi: 10.1007/s00431.017.2994–9.


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For citations:


Mukhametshin R.F., Davidova N.S. Structure of causes of non-transportability of newborns. EMERGENCY MEDICAL CARE. 2022;23(2):31-37. (In Russ.) https://doi.org/10.24884/2072-6716-2022-23-2-31-37

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