Factors Associated with Clinical Complications During Intra-hospital Transports in a Neonatal Unit in Brazil

Vieira, Anna Luiza Pires; Santos, Amélia Miyashiro Nunes dos; Okuyama, Mariana Kobayashi; Miyoshi, Milton Harumi; Almeida, Maria Fernanda Branco de; Guinsburg, Ruth

doi:10.1093/tropej/fmq111

Cited by 32 publications

(26 citation statements)

References 24 publications

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“…(1,2) The intrahospital transport is a period of instability and risk to patients, with the possibility of complications related to technical failures, physiological changes of patients, duration of transport, and with the team that performs it. (3)(4)(5) Furthermore, it must be taken into account that the sectors for which the patient is referred to not always have the same equipment that the intensive care unit. In this context, the indication, planning, implementation and stabilization after the procedure are of extreme importance in order to minimize complications and unnecessary risks to the patient.…”

Section: Introductionmentioning

confidence: 99%

Caracterização do transporte de pacientes críticos na modalidade intra-hospitalar

2014

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Objective: Characterizing the transport of critically ill patients in an adult intensive care unit. Methods: Cross-sectional study in which 459 intra -hospital transports of critically ill patients were included. Data were collected from clinical records of patients and from a form with the description of the materials and equipment necessary for the procedure, description of adverse events and of the transport team. Results: A total of 459 transports of 262 critically ill patients were carried out, with an average of 51 transports per month. Patients were on ventilatory support (41.3 %) and 34.5 % in use of vasoactive drugs. Adverse events occurred in 9.4% of transports and 77.3 % of the teams were composed of physicians, nurses and nurse technicians. Conclusion: The transport of critically ill patients occurred in the morning period for performing computerized tomographies (CT scans) with patients dependent on mechanical ventilation and vasoactive drugs. During the transports the equipment was functioning, and the adverse events were attributed to clinical changes of patients. ResumoObjetivo: Caracterizar o transporte de pacientes críticos em unidade de terapia intensiva adulto. Métodos: Estudo transversal onde foram incluídos 459 transportes de pacientes críticos na modalidade intrahospitalar. Os dados foram coletados nos prontuários clínicos dos pacientes e em um formulário com a descrição dos materiais e equipamentos necessários ao procedimento, descrição de ocorrências adversas e da equipe que realizou. Resultados: Foram realizados 459 transportes de 262 pacientes críticos com média de 51 transportes por mês. Eram pacientes em suporte ventilatório (41,3%) e 34,5% em uso de drogas vasoativas. Em 9,4% dos transportes ocorreram eventos adversos sendo 77,3% das equipes compostas por médico, enfermeiro e técnico de enfermagem. Conclusão: Os transportes de pacientes críticos ocorreram no período da manhã, para realização de tomografia computadorizada, com pacientes dependentes de suporte ventilatório e drogas vasoativas. Os equipamentos durante o transporte estavam funcionando e, os eventos adversos ocorridos foram atribuídos a alterações clínicas dos pacientes.

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Section: Introductionmentioning

confidence: 99%

Caracterização do transporte de pacientes críticos na modalidade intra-hospitalar

2014

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“…These changes have the capacity to leave the brain at risk for oxygen and glucose perturbations and/or lead to hemodynamic changes that could alter cerebral perfusion. These physiologic challenges may complicate underlying conditions such as respiratory distress, and thermal stress (Viera et al, 2010).…”

Section: Historical Trends In Intra-hospital Transport Of the Newbornmentioning

confidence: 99%

“…Clinical complications occurred in 27.3% of infants, including use of supplemental oxygen, increase in mechanical ventilation and hypothermia. Additionally loss of intravenous cannula (3.1%) and accidental extubation (0.6%) was noted (Viera et al, 2010). Cerebral hemodynamic changes during intensive care of preterm neonates was the focus of a recently published article (Limperopoulos et al, 2008).…”

Section: Current Mechanisms Of Newborn Intrahospital Transportmentioning

confidence: 99%

“…Classic in-house transport for sick newborns requires successive transfers of the infant; in many hospitals, moving sick newborns from the L&D to the NICU requires transfer from a radiant warmer to an incubator or use of a transport incubator for transfer to the NICU. This usually means significant thermal stress as well as possible respiratory and hemodynamic instability (Viera et al, 2010). Preventing evaporative, convective and conductive heat loss in the newborn and maintenance of the neutral thermal environment are routine nursing practices and neonatal standards of care.…”

Section: Current Mechanisms Of Newborn Intrahospital Transportmentioning

confidence: 99%

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Risk factors for intra-hospital transport of newborn patients: A new solution to an old problem

Loersch

Schindler

Starr³

et al. 2011

Journal of Neonatal Nursing

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“…[ 2 , 3 ] Hypothermia has been reported to be the most significant side effect associated with transport, especially in preterm infants. [ 1 , 3 , 4 ] Other side effects, including hypoglycemia, variations in blood pressure and heart rate, endotracheal dislocation, and changes in blood glucose level, have also been reported. [ 1 , 5 ] Body weight is thought to be the most important risk factor for outcomes associated with the transport of critical patients.…”

Section: Introductionmentioning

confidence: 99%

The beneficial effect of air cleanliness with ISO 14644-1 class 7 for surgical intervention in a neonatal intensive care unit

Lin

et al. 2018

Medicine

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Whether critically ill neonates needing a surgical intervention should be transferred to an operating room (OR) or receive the intervention in a neonatal intensive care unit (NICU) is controversial. In this study, we report our experience in performing surgical procedures in a NICU including air cleanliness.This was a retrospective study performed at a metropolitan hospital. The charts of all neonates undergoing surgical procedures in the NICU and OR were retrospectively reviewed from January 2007 to June 2017. Data on baseline characteristics, procedure and duration of surgery, ventilator use, hypothermia, instrument dislocations, surgery-related infections and complications, and outcomes were analyzed.Ninety-two neonates were enrolled in this study, including 44 in the NICU group and 48 in the OR group. The air cleanliness was International Organization for Standardization (ISO) 14644-1 class 7 in the NICU and class 5-6 in the OR. The NICU group had a younger gestational age and lower birth body weight than the OR group. The OR group had a higher incidence of hypothermia than in the NICU group (56.3% vs 9.1%, P < .001). However, there were no significant differences in surgical site related infections or mortality between the 2 groups.This study suggests that performing surgical procedures in a NICU with air cleanliness class 7 is as safe as in an OR, as least in part, when performing patent ductus arteriosus ligation and exploratory laparotomy.

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Factors Associated with Clinical Complications During Intra-hospital Transports in a Neonatal Unit in Brazil

Abstract: Intra-hospital transports are associated with increased risk of clinical complications.

Cited by 32 publications

References 24 publications

Caracterização do transporte de pacientes críticos na modalidade intra-hospitalar

Caracterização do transporte de pacientes críticos na modalidade intra-hospitalar

Risk factors for intra-hospital transport of newborn patients: A new solution to an old problem

The beneficial effect of air cleanliness with ISO 14644-1 class 7 for surgical intervention in a neonatal intensive care unit

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