Adverse Events and Associated Factors During Intra-Hospital Transport of Newborn Infants

Background: Hospitalized neonates can require intra-hospital transport to perform diagnostic or therapeutic procedures. A number of studies attest the risks of intra-hospital transport of critically ill adults and children, but literature concerning newborns is scarce. We sought to determine the incidence, the type and the severity of adverse events during intra-hospital transport of newborns, and to identify associated factors. Methods: We conducted a prospective observational study in one academic tertiary care neonatal unit. All patients hospitalized in the neonatal unit and undergoing intra-hospital transport between 1.6.2015 and 31.5.2017 were included. Transports from other hospitals and delivery room were not included. Findings: Data from 990 intra-hospital transports performed in 293 newborns were analysed. Median postnatal age at transport was 13 days (Q1-Q3 5-44). Adverse events occurred during 248 transports (248/990, 25%). Adverse events were associated with no harm in 207 transports (207/990, 21%), mild harm in 36 transports (36/990, 4%), and moderate harm in 5 transports (5/990, 1%). There was no severe or lethal adverse event. Hemodynamic support with catecholamines, presence of a central venous catheter, a lower birthweight, a higher postnatal age, and a longer duration of transport were independent predictors for the occurrence of complications during transport. In the 169 transports performed under mechanical ventilation, we did not observe changes in heart rate or deterioration of oxygenation during and after transport. Interpretation: Intra-hospital transports of newborns are frequent, and a substantial proportion are associated with adverse events of low to moderate severity. This underscores the need for development of specific guidelines. Funding: No specific funding was obtained for this study. Declaration of Interests: The authors have no conflicts of interest relevant to this article to disclose. Ethics Approval Statement: The study was approved by the Cantonal Ethics Committee of Vaud (Lausanne, Switzerland). The need for informed consent was waived due to the observational nature of the study.