ABSTRACT
INTRODUCTION
Hospitalized neonates often require internal transportation to perform diagnostic or therapeutic procedures that cannot be done at the bedside. A number of studies attest the risk of intra-hospital transportation of adults and children hospitalized in intensive care, but literature concerning newborns is sparse.
OBJECTIVES
Determine the incidence of complications during intra-hospital transportation of newborns, identify neonatal or transport factors associated with adverse events during transport and assess physiological changes occurring during these transports.
METHODOLOGY
We conducted a prospective observational study from the 1/6/15 to the 1/6/16 in the NICU of the University Hospital of Lausanne, Switzerland. All newborns hospitalized in the NICU undergoing intra-hospital transportation were included.
RESULTS
138 newborns of a median gestational age of 37 weeks (Q1-Q3 30-39 weeks) and of birth weight 2470g (Q1-Q3 1296-3200 g) underwent 429 intra-hospital transports for diagnostic or therapeutic procedures. Reasons for transport included 130 MRIs (30%), 98 surgeries (23%), 65 ultrasounds (15%), 42 endoscopies (10%), 20 CT scans (5%), and 74 other reasons, including TOGDs, enemas and CUMs. 103 adverse events occurred during 79 (18.4%) intra-hospital transports, including 24 (5.6%) desaturations, 22 (5.1 %) agitations, 20 (4.5%) hypothermia events. No adverse event was moderate, severe or led to death of the newborn. Factors associated with complicated transports included low gestational weight and age, underlying cardiovascular disease or symptoms requiring transport, the use of morphine and of mechanical ventilation, return transports, time out of NICU and transports from surgery and bronchoscopy rooms. There was no significant modification of vital signs during transportation in a selected group of mechanically ventilated newborns.
CONCLUSION
This study confirms that there remains a high number of low-risk events during intra- hospital transportation of newborns. This should raise awareness among staff attending diagnostic and therapeutic procedures outside the NICU, but also among transport staff when confronted to newborns of with transport, material or patient- related characteristics associated with adverse events. Absence of severe complications indicates that newborns can be safely transported within the hospital. Nonetheless, the significant resources required for a safe transport advocates for more procedures to be performed at the bedside.