Prem Arora1, Monika Bajaj1, Girija Natarajan1, Natasha Purai Arora2, Vaneet Kumar Kalra1, Marwan Zidan3, Seetha Shankaran1. 1. Division of Neonatal-Perinatal Medicine, The Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit Medical Center, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan. 2. Department of Internal Medicine, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan. 3. The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan.
Abstract
OBJECTIVES: To evaluate the change in physiologic stability of very low-birth-weight (VLBW) infants following transport using TRIPS (transport risk index of physiologic stability) score as a measure of physiologic stability and compare changes in TRIPS score in groups of VLBW infants who underwent shorter versus longer transport. STUDY DESIGN: Retrospective chart review. RESULTS: Our cohort of 106 infants, 44 (41%) of whom were females, had a mean birth weight of 777 g (standard deviation [SD] 159) and median gestational age of 26 weeks (range 23 to 32 weeks). Mean weight at transfer was 1,610 g (SD 924) and mean postnatal age at transfer was 56 days (SD 45). Median time on transport was 15 minutes (range 10 to 85 minutes). All 106 transports were ground transports. Of the 106 infants, 57 (54%) had deterioration, 20 (19%) had improvement, and 29 (27%) had no change in their physiologic status during transport. Comparison of the two transport duration groups based on median transport time as a cutoff point (i.e., ≤ 15 minutes and > 15 minutes) revealed a higher proportion of infants with deterioration in their physiologic status in the prolonged transport (>15 minutes) group (65% versus 45%; p = 0.03). Temperature change, either alone or in combination with other indices, was responsible for change in TRIPS score (deterioration or improvement) in 79% of these infants. CONCLUSIONS: Interhospital transport of VLBW infants may cause deterioration in their physiologic status, the likelihood of which is increased with longer duration of transport. Better temperature regulation during interhospital transport may decrease the chances of deterioration in physiologic status of VLBW infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVES: To evaluate the change in physiologic stability of very low-birth-weight (VLBW) infants following transport using TRIPS (transport risk index of physiologic stability) score as a measure of physiologic stability and compare changes in TRIPS score in groups of VLBW infants who underwent shorter versus longer transport. STUDY DESIGN: Retrospective chart review. RESULTS: Our cohort of 106 infants, 44 (41%) of whom were females, had a mean birth weight of 777 g (standard deviation [SD] 159) and median gestational age of 26 weeks (range 23 to 32 weeks). Mean weight at transfer was 1,610 g (SD 924) and mean postnatal age at transfer was 56 days (SD 45). Median time on transport was 15 minutes (range 10 to 85 minutes). All 106 transports were ground transports. Of the 106 infants, 57 (54%) had deterioration, 20 (19%) had improvement, and 29 (27%) had no change in their physiologic status during transport. Comparison of the two transport duration groups based on median transport time as a cutoff point (i.e., ≤ 15 minutes and > 15 minutes) revealed a higher proportion of infants with deterioration in their physiologic status in the prolonged transport (>15 minutes) group (65% versus 45%; p = 0.03). Temperature change, either alone or in combination with other indices, was responsible for change in TRIPS score (deterioration or improvement) in 79% of these infants. CONCLUSIONS: Interhospital transport of VLBW infants may cause deterioration in their physiologic status, the likelihood of which is increased with longer duration of transport. Better temperature regulation during interhospital transport may decrease the chances of deterioration in physiologic status of VLBW infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Sarah N Kunz; Dmitry Dukhovny; Jochen Profit; Wenyang Mao; David Miedema; John A F Zupancic Journal: J Pediatr Date: 2018-10-02 Impact factor: 4.406
Authors: S N Kunz; J A F Zupancic; J Rigdon; C S Phibbs; H C Lee; J B Gould; J Leskovec; J Profit Journal: J Perinatol Date: 2017-03-23 Impact factor: 2.521
Authors: Itziar Marsinyach Ros; Laura Sanchez García; Ana Sanchez Torres; Rocio Mosqueda Peña; Maria Del Carmen Pérez Grande; Maria José Rodríguez Castaño; Maria Dolores Elorza Fernández; Manuel Sánchez Luna Journal: Eur J Pediatr Date: 2020-01-28 Impact factor: 3.183
Authors: John A F Zupancic; Jochen Profit; Sarah N Kunz; Daniel Helkey; Marinka Zitnik; Ciaran S Phibbs; Joseph Rigdon Journal: J Perinatol Date: 2021-05-25 Impact factor: 2.521