Neonatal Transport Facilities and Its Effect on Outcome: An Experience from Tertiary Care Hospital of Central Gujarat

Abstract

Background:This study regarding the transport facilities prevailing in areas surrounding our hospital and the immediate outcome of such transported neonates in terms of morbidity and mortality will provide us an insight into the scope for improvement in the facilities and thus will help in the reduction of mortality of the extramural neonates.Material and method:In this prospective observational study, details of all transported extramural sick neonates were obtained regarding the transport facility availed by the patient. The physiology on arrival and immediate outcome were compared between survived and expired neonates.Results:Out of 82 neonates enrolled in the study, the majority (38 [48.7%]) had sepsis. The majority of neonates were low birth weight (49 [59.8%]) and preterm (47 [57.3%]). In all, 80.5% of the transported neonates were referred from private pediatric hospitals. Free Government ambulance facility (108) was utilized by only 6 (7.3%). Significantly a greater number of moderately hypothermic neonates were there in the expired group versus the survived group (66.7% vs 20%, p =0.013). Capillary refill time of ≥3 seconds on arrival was significantly associated with poor outcomes (66.7% vs 20%, p =0.013). Saturation levels of <70% on arrival are significantly associated with poor outcome (66.7% vs 6%, p <.0001).Conclusion:This study emphasizes the need for appropriate care and management to be provided to critical neonates during transport to maintain hemodynamic stability and improved vitals on arrival to the referred center for a better final outcome.