Amir Zayegh1, Michael Stewart2,3, Carmel Delzoppo3,4, Bennett Sheridan3,4,5. 1. Newborn Care Unit, John Radcliffe Hospital, Oxford, UK. Amir.Zayegh@ouh.nhs.uk. 2. Paediatric Infant and Perinatal Retrieval Service (PIPER), The Royal Children's Hospital, Melbourne, VIC, Australia. 3. Murdoch Children's Research Institute, Melbourne, VIC, Australia. 4. Paediatric Intensive Care Unit, The Royal Children's Hospital, Melbourne, VIC, Australia. 5. Department of Cardiology, The Royal Children's Hospital, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: To assess the effect of reducing retrieval team response time on the outcomes of babies born outside a cardiac centre (outborn) with antenatally diagnosed transposition of the great arteries. STUDY DESIGN: Retrospective cohort study of all outborn babies with antenatally diagnosed TGA anticipated to require transfer for urgent balloon atrial septostomy over a 6-year period (15 babies pre intervention and 27 post intervention). The intervention involved a collaborative multicomponent practice change aiming to reduce retrieval team response time. RESULT: The mean (SD) time from birth to cardiac ICU arrival was 159 (12) min pre intervention and 103 (6) min post intervention (mean difference -57 min [95% CI, -81 to -32]). There was a significant decrease in need for extracorporeal membrane oxygenation (33% versus 4%), RR 0.11 [95% CI, 0.02-0.65]), with a number needed to treat of 3.4 to prevent one ECMO episode. CONCLUSION: Reducing retrieval time is achievable with collaborative systems, and significantly improves clinical outcomes.
OBJECTIVE: To assess the effect of reducing retrieval team response time on the outcomes of babies born outside a cardiac centre (outborn) with antenatally diagnosed transposition of the great arteries. STUDY DESIGN: Retrospective cohort study of all outborn babies with antenatally diagnosed TGA anticipated to require transfer for urgent balloon atrial septostomy over a 6-year period (15 babies pre intervention and 27 post intervention). The intervention involved a collaborative multicomponent practice change aiming to reduce retrieval team response time. RESULT: The mean (SD) time from birth to cardiac ICU arrival was 159 (12) min pre intervention and 103 (6) min post intervention (mean difference -57 min [95% CI, -81 to -32]). There was a significant decrease in need for extracorporeal membrane oxygenation (33% versus 4%), RR 0.11 [95% CI, 0.02-0.65]), with a number needed to treat of 3.4 to prevent one ECMO episode. CONCLUSION: Reducing retrieval time is achievable with collaborative systems, and significantly improves clinical outcomes.