Charles Mullins. Impact of Hospital Transfer and Timing of Surfactant Delivery on NICU Length of Stay

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Presenter/Author:  Charles Mullins, MD
Resident, University of Texas Medical Branch, Pediatrics

Contributing Authors/Faculty Mentor:  Marie Dawlett, MD 
and David Rasin, PhD
University of Texas Medical Branch



POSTER ABSTRACT  (View Poster PDF)

Patients that require admission to neonatal intensive care units have a variety of medical conditions and outcomes. At our institution we have deliveries that occur on a satellite campus and sometimes these patient require transport if NICU admission is needed. Transportation of ill neonates and the timing of surfactant delivery can have impact on the outcomes of the NICU stay (1,2,3,4). This retrospective chart review was designed to compare outcomes of newborns born at satellite UTMB nurseries requiring transport to the UTMB main campus NICU. Transfers were matched with controls born at UTMB main campus. There was no significant difference in time to surfactant therapy, length of stay, or respiratory support due to small sample sizes. The mean time to surfactant therapy was longer in the transferred patients. Overall the length of stay was shorter for transferred patients, but when separated, the patients’ with transient tachypnea of the newborn and respiratory distress syndrome of the newborn had slightly longer mean length of stay and mean length of respiratory support compared to controls. 

References:
1: Karagol BS, Zenciroglu A, Mehmet SI, Ahmet AK, Nurullah O. Impact of Land-Based Neonatal Transport on Outcomes in Transient Tachypnea of the Newborn. American Journal of Perinatology. 2011: Apr:28(4):331-6
2. Mori R, Fujimura M, Shiraishi J, Evans B, Corkett M, Negishi H, Doyle P; Duration of Inter-Facility Neonatal Transport and Neonatal Mortality: Systematic Review and Cohort Study. Pediatrics International 2007 Aug;49(4):452-8
3. Engle WA; American Academy of Pediatrics Committee on Fetus and Newborn. Surfactant-replacement therapy for respiratory distress in preterm and term neonate.  Pediatrics. 2008;121(2):419-432
 
4. Stevens TP, Harrington EW, Blennow M, Soll RF. Early surfactant administration with brief ventilation vs selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database Syst Rev 2007;(4): CD003063
 
5:  Rojas-Reyes MX, Morley CJ, Soll R. Prophylactic verses selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2012;3(3): CD000510