Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1070-1077 (doi:10.1542/peds.2006-0719)

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Yeager, S. B. Articles by Laussen, P. C. Search for Related Content PubMed PubMed Citation Articles by Yeager, S. B. Articles by Laussen, P. C. Related Collections Heart & Blood Vessels

ARTICLE

Pretransport and Posttransport Characteristics and Outcomes of Neonates Who Were Admitted to a Cardiac Intensive Care Unit

Scott B. Yeager, MD^a, Jeffrey D. Horbar, MD^b, Karla M. Greco, MHS^a, Julianna Duff, MBBS^c, Ravi R. Thiagarajan, MD, MPH^c and Peter C. Laussen, MBBS^c

^a Department of Pediatrics, University of Vermont School of Medicine, Burlington, Vermont
^b Center for Patient Safety in Neonatal Intensive Care, Vermont Oxford Network, Burlington, Vermont
^c Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts

OBJECTIVE. The objective for this study was to characterize the impact and the safety of transporting neonates with known or suspected cardiac abnormalities.

METHODS. We reviewed retrospectively the charts and computerized records of 192 admissions to a cardiac ICU in 2002. Patients were included when they were <28 days of age at admission and were transported from adjacent obstetric facilities (local N = 70) or other inpatient medical facilities (transport N = 122). Demographic, clinical, pharmacologic, laboratory, and diagnostic information was obtained before transport (when available) and within 3 hours of arrival. Arrival status was considered optimal when measured metabolic and clinical parameters all were within range. Outcome variables included days on ventilator, days in ICU, days in hospital, and death.

RESULTS. Of local admissions, 31 (44%) patients had 61 suboptimal arrival values, including pH <7.25 (n = 11), saturation <70% (n = 12), and temperature <36°C (n = 9). There were 69 undocumented values in 39 patients. Of transported patients, 55 (45%) had 86 suboptimal arrival values, including pH <7.25 (n = 8), saturation <70% (n = 14), and temperature <36°C (n = 13). There were 98 undocumented values in 53 patients. No in-transport deaths or catastrophic events occurred. Local admissions were more likely to have a prenatal diagnosis of heart disease and had more complex disease and higher mortality. Other outcome parameters were not significantly different between the 2 groups. Low admission arterial saturation, pH, and core temperature were not correlated with adverse outcome measures.

CONCLUSIONS. Although we did not encounter major transport complications, opportunities exist to optimize arrival status and improve surveillance and documentation.

---

Key Words: congenital heart defects • transportation of patients • cardiac surgical procedures • cardiac care facilities

Abbreviations: CHB—Children's Hospital Boston • RACHS-1—Risk Adjustment for Congenital Heart Surgery-1 • APV—absent pulmonary valve • CAVC—complete atrioventricular canal

---

Accepted May 4, 2006.

This article has been cited by other articles:

				G. D. Meckler and C. Lowe To Intubate or Not to Intubate? Transporting Infants on Prostaglandin E1 Pediatrics, January 1, 2009; 123(1): e25 - e30. [Abstract] [Full Text] [PDF]

				B. A. Kuch, R. Munoz, R. A. Orr, and R. S. Watson Unplanned Transport Events and Severity of Illness: Are We Conveying the Whole Picture? Pediatrics, March 1, 2007; 119(3): 648 - 649. [Full Text] [PDF]