Abstract
Objective
The aim of this study was to characterize vital sign abnormalities, trajectories,
and related risk factors during neonatal transport.
Methods
We performed a retrospective analysis of neonates transported within a US regional
care network in 2020 to 2021. Demographic and clinical data were collected from electronic
records. Group-based trajectory modeling was applied to identify groups of neonates
who followed distinct vital sign trajectories during transport. Patients with conditions
likely to impact the assessed vital were excluded. Risk factors for trajectories were
examined using modified Poisson regression models.
Results
Of the 620 neonates in the study, 92% had one abnormal systolic blood pressure (SBP)
measure, approximately half had an abnormal heart rate (47%) or temperature (56%),
and 28% had an abnormal oxygen saturation measure during transport. Over half (53%)
were in a low and decreasing SBP trajectory, and 36% were in a high and increasing
heart rate trajectory. Most infants ≤ 28 weeks postmenstrual age had 2 or more concerning
vital sign trajectories during transport.
Conclusion
Abnormal vital signs were common during neonatal transport, and potentially negative
trajectories in heart rate and SBP were more common than temperature or oxygen saturation.
Transport teams should be trained and equipped to detect concerning trends and respond
appropriately while en route.
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Article info
Publication history
Published online: September 14, 2022
Footnotes
Supported by the Agency for Healthcare Research and Quality (grant no. HS027259-01).
Identification
Copyright
© 2022 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.
