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Newborn infants with bilious vomiting: a national audit of neonatal transport services.
Ojha, Shalini; Sand, Laura; Ratnavel, Nandiran; Kempley, Stephen Terence; Sinha, Ajay Kumar; Mohinuddin, Syed; Budge, Helen; Leslie, Andrew.
Afiliação
  • Ojha S; Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Derby, UK.
  • Sand L; Neonatal Unit, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK.
  • Ratnavel N; Division of Child Health, School of Medicine, University of Nottingham, Nottingham, UK.
  • Kempley ST; London Neonatal Transfer Service, The Royal London Hospital, Barts Health NHS Trust, London, UK.
  • Sinha AK; Blizard Institute, Queen Mary University of London, London, UK.
  • Mohinuddin S; Paediatrics, Barts Health NHS Trust, London, UK.
  • Budge H; Paediatrics, Barts and the London School of Medicine and Dentistry, London, UK.
  • Leslie A; Paediatrics, Barts Health NHS Trust, London, UK.
Arch Dis Child Fetal Neonatal Ed ; 102(6): F515-F518, 2017 Nov.
Article em En | MEDLINE | ID: mdl-28483818
OBJECTIVE: The precautionary approach to urgently investigate infants with bilious vomiting has increased the numbers referred to transport teams and tertiary surgical centres. The aim of this national UK audit was to quantify referrals and determine the frequency of surgical diagnoses with the purpose to inform the consequent inclusion of these referrals in the national 'time-critical' data set. METHODS: A prospective, multicentre UK-wide audit was conducted between 1 August, 2015 and 31 October, 2015. Term infants aged ≤7 days referred for transfer due to bilious vomiting were included. Data at the time of transport and outcomes at 7 days after transfer were collected by the local teams and transferred anonymously for analysis. RESULTS: Sixteen teams contributed data on 165 cases. Teams that consider such transfers as 'time-critical' responded significantly faster than those that do not classify bilious vomiting as time-critical. There was a surgical diagnosis in 22% cases, and 7% had a condition where delayed treatment may have caused bowel loss. Most surgical problems could be predicted by clinical and/or X-ray findings, but two infants with normal X-ray features were found to have a surgical problem. CONCLUSION: The results support the need for infants with bilious vomiting to be investigated for potential surgical pathologies, but the data do not provide evidence for the default designation of such referrals as 'time-critical.' Decisions should be made by clinical collaboration between the teams and, where appropriate, swift transfer provided.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Vômito / Transferência de Pacientes Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: Arch Dis Child Fetal Neonatal Ed Assunto da revista: PEDIATRIA / PERINATOLOGIA Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Vômito / Transferência de Pacientes Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: Arch Dis Child Fetal Neonatal Ed Assunto da revista: PEDIATRIA / PERINATOLOGIA Ano de publicação: 2017 Tipo de documento: Article