Volume 41 Supplement 1

XXI Congress of the Italian Society of Neonatology

Open Access

New technologies applied to neonatal transport

Italian Journal of Pediatrics201541(Suppl 1):A26

https://doi.org/10.1186/1824-7288-41-S1-A26

Published: 24 September 2015

As neonatal care in the tertiary setting advances, neonatal transport teams are challenged with incorporating the innovations into their work environment. Some advancements over the last years involve communication, respiratory management, hypothermia, newborn comfort.

Communication

The communication gold standard is the implementation of advanced technologiesas establishment of areal-time telepresence clinical network that allows online collaboration between primary care physicians working in community hospitals and critical care transport teams on moving vehicles. These participants will be able to work in collaborationduring the evaluation, stabilization and transfer of critically ill newborns.

Respiratory management

Many major respiratory treatments and the equipment required have been adapted for transport. There is evidence that new methods of non invasive ventilation support have significantly changed RDS management in preterm infants. Further perspectives for neonatal transport teams involve the assessment of NIV strategies. If the infant is less than 28 weeks, has an air leak, or has persistentpulmonaryhypertension, the team may elect to place the infant on high frequencyventilation. To date two modes of HFV has been studied in the care of infants: high frequency oscillatory ventilation (HFOV) and high frequency jet ventilation (HFJV). However, transport with the HFO is not a current option as it does not have external battery power. HFJV can be used for transport as it has an external battery. After ventilation is established, the team assesses the need for surfactant. The administration of surfactant prior to transport determine a significantly greater drop in oxygen requirement and appears to be very safe. Infants requiring high ventilator support, such as infants with PPH, may require conventional ventilation and inhalednitricoxideor more commonly iNO and HFV. Infants are usually started on iNO at 20 ppm, a dose that has been found very effective to achieve positive results.

Hypothermia

Ideally all infants who are being considered for cooling should have a preliminary CFM recording prior to starting active cooling. A new system has been purchased to provide a portable means of undertaking a CFM assessment at referring sites for infants who are being considered for transfer for therapeutic cooling. In these infants the use of active cooling using servo-controlled cooling mattress during transfer achieves target temperature in a significantly shorter period and maintains better temperature stability during transfer.

Newborn comfort

All babies showed higher levels of discomfort during transport. Discomfort is increased by mechanical ventilation or other invasive procedures. Analgo-sedation improve outcome of newborn during transport.

Authors’ Affiliations

(1)
Neonatal Intensive Care Unit and Neonatal Emergency Transport, A.O.R.N. Sant'Anna e San Sebastiano

References

  1. Falco L, Panico M: Vademecum del Trasporto Neonatale d'Emergenza. 2008, III EdizioneGoogle Scholar
  2. Qureshi A, Shih E, Fan I, Carlisle J, Brezinski D, Kleinman M, Guttag J: Improving patient care by unshackling telemedicine: adaptively aggregating wireless networks to facilitate continuous collaboration. Amiaannusymp proc. 2010, 2010: 662-666.Google Scholar
  3. Panico M, Abbate L, Ansalone A, Ausanio G, Bernardo I, Brescia D, Capasso A, Crispino F, D'Angelo D, Grassia C, Mastroianni R, Rossi V, Vendemmia M, Falco P, Clarizia F, Romano A: Creazione di una rete informatica tra centri nascita, centrale operativa del Trasporto Neonatale d'Emergenza e unità di Terapia Intensiva Neonatale - XX Congresso Nazionale della S.I.N., poster P024. 2014Google Scholar
  4. Coe KL, Jamie SF, Baskerville RM: Managing common neonatal respiratory conditions during transport. Adv Neonatal Care. 2014, 14 (Suppl 5): S 3-10.View ArticleGoogle Scholar
  5. Mainali ES, Greene C, Rozycki HJ, Gutcher GR: Safety and efficacy of high-frequency jet ventilation in neonatal transport. J perinatol. 2007, 27 (10): 609-613. 10.1038/sj.jp.7211799.View ArticlePubMedGoogle Scholar
  6. Mildenhall LF, Pavuluri NN, Bowman ED: Safety of synthetic surfactant use before preterm newborn transport. J paediatr child health. 1999, 35 (6): 530-535. 10.1046/j.1440-1754.1999.00414.x.View ArticlePubMedGoogle Scholar
  7. Lutman D, Petros A: Inhaled nitric oxide in neonatal and paediatric transport. Early Hum Dev. 2008, 84 (11): 725-729. 10.1016/j.earlhumdev.2008.08.003.View ArticlePubMedGoogle Scholar
  8. De Vries LS, Hellström-westas L: Role of cerebral function monitoring in the newborn. Arch dis child fetal neonatal Ed. 2005, 90 (3): f 201-207. 10.1136/adc.2004.062745.View ArticleGoogle Scholar
  9. Chaudhary R, Farrer K, Broster S, McRitchie L, Austin T: Active Versus Passive Cooling During Neonatal Transport. Pediatrics. 2013, 132: 841-10.1542/peds.2013-1686.View ArticlePubMedGoogle Scholar
  10. Falco L, Panico M, Falco P: Analgosedazione del neonato in ventilazione meccanica nel Trasporto Neonatale d'Emergenza. XVII Congresso Nazionale della S.I.N., poster P041. 2011Google Scholar

Copyright

© Panico 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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