Neonatal Vital Sign Trajectories and Risk Factors During Transport Within a Regional Care Network.
Neonatal Vital Sign Trajectories and Risk Factors During Transport Within a Regional Care Network.
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DOI：
10.1016/j.amj.2022.08.002
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发表时间：
2022-11-01
影响因子：
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通讯作者：
Umoren, Rachel A
中科院分区：
文献类型：
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作者：
Greene, Nancy D;Riley, Taylor;Umoren, Rachel A
目的：本研究的目的是描述生命体征异常，轨迹和相关的危险因素在新生儿transport.METHODS：我们进行了回顾性分析，在2020年至2021年在美国区域护理网络内运送的新生儿。从电子记录中收集人口统计学和临床数据。应用基于组的轨迹建模来识别在运输过程中遵循不同生命体征轨迹的新生儿组。排除了可能影响评估的生命体征的患者。轨迹的危险因素进行了检查，使用修改后的Poisson回归models.Results：在研究中的620名新生儿，92%有一个异常的收缩压（SBP）的措施，大约一半有一个异常的心率（47%）或温度（56%），和28%的运输过程中有一个异常的血氧饱和度测量。超过一半（53%）处于低收缩压和收缩压下降轨迹，36%处于高心率和心率上升轨迹。大多数≤ 28周的婴儿在转运过程中有2个或更多的生命体征轨迹。结论：新生儿转运过程中常见异常生命体征，心率和收缩压的潜在负轨迹比体温或血氧饱和度更常见。运输团队应得到培训和装备，以发现有关趋势，并在途中作出适当反应。
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.