Factors Affecting Stabilization Times in Neonatal Transport.

OBJECTIVE: During transport, the time spent in stabilizing sick infants before repatriation is crucial in optimizing the outcome and effective use of resources. The study aim was to assess individual components of neonatal transport time to identify opportunities to minimize delay, optimize care, and improve the overall efficiency of transport. METHODS: A single-center prospective observational study conducted at McMaster Children's Hospital, Hamilton, Ontario, Canada, with a dedicated transport team for over 12 months. The stabilization time was defined as the time interval between arrival and departure from the referring hospital. RESULTS: Of 223 neonatal transfers, 67 required no procedural or therapeutic intervention before mobilization to the receiving unit, with a mean stabilization time of 113 ± 52 minutes. In 156 transport events, 1 or more interventions were required, with a significantly higher mean stabilization time of 165 ± 89 minutes (P < .0001). CONCLUSION: This study found that the local stabilization time was more than 1.5 times that of the comparable published data. The reasons identified for this delay were mostly because of waiting times for vehicle mobilization, waiting for blood and radiology results, and bed availability. Modifying these factors could save up to 28% of the stabilization time.

Macrolides do not affect the incidence of moderate and severe bronchopulmonary dysplasia in symptomatic ureaplasma-positive infants.

AIM: The aim of this study was to compare the incidence of bronchopulmonary dysplasia (BPD) in symptomatic ureaplasma-positive treated preterm infants and asymptomatic preterm infants not tested or treated for ureaplasma. METHODS: A retrospective matched cohort study was conducted in a tertiary, neonatal unit between January 2007 and December 2012. Infants ≤29 completed weeks with signs and symptoms suggesting ureaplasma pneumonia who received macrolides comprised the study group. Infants ≤29 weeks without signs and symptoms not tested or treated with macrolides were the controls. Infants were mandatorily matched for gestational age ± one week or birthweight ± 100 grams. RESULTS: There were 31 infants in the study group and 62 in the control group. The baseline demographic data of both groups were similar on the whole. The incidence of moderate and severe BPD, defined by oxygen dependency or the need for continuous positive airway pressure at 36 weeks of postconceptual age, was 45.2% in the study group and 40.3% in the controls (p = 0.65). There was no significant difference in morbidities or mortality between the groups. CONCLUSION: A selective approach of treating symptomatic ureaplasma-positive preterm infants with macrolides did not affect the incidence of moderate and severe BPD.