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- Title
Feasibility and utility of portable ultrasound during retrieval of sick preterm infants.
- Authors
Browning Carmo, Kathryn; Lutz, Tracey; Greenhalgh, Mark; Berry, Andrew; Kluckow, Martin; Evans, Nick
- Abstract
<bold>Aim: </bold>Document the incidence of haemodynamic pathology in critically ill preterm newborns requiring transport.<bold>Method: </bold>A transport neonatologist performed cardiac and cerebral ultrasound before and after transportation of infants born ≤30 weeks gestation.<bold>Results: </bold>Forty-four newborns were studied in 2008-2015; of them, 21 were transported by road, 19, by helicopter and four, by fixed wing: median birthweight, 1130 g (680-1960 g) and median gestation, 27 weeks (23-30); 30 of 44 were male babies. Antenatal steroid course was complete in two babies. Ultrasound in the referring hospital was at a mean of two hours: 47 minutes (00:15-7:00) of age. Low systemic blood flow was common: 50% had right ventricular output <150mL/kg/min and 23%, a superior vena cava flow <50mL/kg/min. at stabilisation. Cranial US: 10 Grade I IVH, 2 Grade II IVH, 1 Grade IV IVH and 32 normal scans pretransport. After transport, three further Grade I IVH were reported. Mortality was higher in the babies with low systemic blood flow: 4 of 12 (33%) died vs 1 of 31 (6%) in the normal flow group (OR = 7.2, 95% CI: 1.1 to 47, p = 0.022).<bold>Conclusion: </bold>Point-of-care ultrasound during the retrieval of preterm infants confirms a high incidence of haemodynamic pathology. The use of ultrasound during transport may provide an opportunity for earlier targeted circulatory support.
- Subjects
ULTRASONIC imaging; PREMATURE infants; CRITICALLY ill patient care; POINT-of-care testing; HEMODYNAMIC monitoring
- Publication
Acta Paediatrica, 2017, Vol 106, Issue 8, p1296
- ISSN
0803-5253
- Publication type
journal article
- DOI
10.1111/apa.13881