Transport of newborn infants for intensive care

Abstract

During the three years 1972–4 222 newborn infants were transported to this hospital for intensive care. They were collected by trained staff using a specially modified transport incubator with an in-built mechanical ventilator and facilities for monitoring body temperature, heart rate, and inspired oxygen concentration. Two of the infants came from home and the rest from 41 hospitals from half a mile (0.8 km) to 50 miles (80.5 km) (median eight miles (12.9 km)) away. The mean birth weight of the infants was 1702 g (range 520–4040 g) and their mean gestational age was 32 weeks (range 24–42 weeks). The principal reasons for referral were low birth weight and severe respiratory illnesses. Altogether 109 (49%) of the infants needed mechanical ventilation in transit and another 38 (17%) needed it later. During the journey the condition of 88 (40%) of the infants was thought to improve, in 125 (56%) it was static and in nine (4%)—four of whom died—it deteriorated. A total of 142 infants (64%) survived the neonatal period. There was no correlation between the distance travelled and the survival rate. Seriously ill newborn infants may be transported safely to a referral centre within a radius of 50 miles, and the risks of the journey are negligible compared with the risks of leaving the infant in a hospital that is not staffed or equipped for neonatal intensive care. © 1975, British Medical Journal Publishing Group. All rights reserved.