A two-year retrospective study of the neonatal emergency transport service in Northeast Italy

Figures & data

Table 1. NETS organization.

The NETS can be activated for 24 h/day, 7 days/week, on request by a Regional Birth Center. The neonatologist of the NICU who receives the transport request from the spoke center is responsible for both activating the emergency transport by calling 112 and recording the data relating to the transport request received (e.g. date/time of the call, identification of the newborn, reason for transport, Apgar score, type of birth). The transport team involved in neonatal transport consists of a neonatologist and a registered nurse on duty at the NICU and with neonatal intensive care experience. In particular, during the night shift, the neonatologist on duty at the NICU must wait for the on-call doctor before carrying out the transport. The team also includes two 112 drivers. The vehicle used is a dedicated ambulance equipped with all the essential equipment (e.g. transport incubator, ventilator, monitor).

NETS: neonatal emergency transport service; NICU: neonatal intensive care unit.

Figure 1. Median transport time related to infants’ weight.

Table 2. Comparison of clinical characteristics of infants with a low birthweight (less than 2500 grams) and infants who weighed more than 2500 grams at birth.

Variable	Infants <2500 grams N = 34/563^b (6.0%)	Infants >2500 grams N = 99/8,437^b (1.2%)	p-value <.001
Gender, n (%)
Male	21 (61.8)	60 (60.6)	.905
Female	13 (38.2)	39 (39.4)
Body weight at NICU admission, median (I quartile - III quartile)	2209 (1755–2340)	3290 (2985–3540)	<.001
GA (weeks), median (I quartile - III quartile)	34 (33–35)	39 (38–40)	<.001
Reason for transport, n (%)
Respiratory failure	15 (44.2)	49 (49.4)	.005
Neurological disorders	4 (11.8)	21 (21.2)
Metabolic disease	4 (11.8)	15 (15.2)
Infections	3 (8.8)	6 (6.1)
Prematurity	7 (20.5)	1 (1.0)
Malformations (e.g. heart defects)	1 (2.9)	7 (7.1)
Apgar score at 1 min, median (I quartile - III quartile)	6 (4–9)	9 (7–10)	.003
Apgar score at 5 min, median (I quartile - III quartile)	8 (7–9)	9 (8–10)	.008
Type of birth, n. (%)
Vaginal delivery	7 (20.6)	63 (63.5)	<.001
Urgent cesarean delivery	23 (67.7)	23 (23.2)
Scheduled cesarean delivery	2 (5.9)	5 (5.1)
Vacuum delivery	1 (2.9)	5 (5.1)
Scheduled induction	1 (2.9)	3 (3.1)
Response time interval^a (min), median (I quartile - III quartile)	33.5 (27.5–39.5)	31.0 (26.0–40.0)	.702
Infant stabilization time (min), median (I quartile - III quartile)	31.5 (23.0–45.0)	23.0 (17.0–30.0)	<.001
Return time (min), median (I quartile - III quartile)	35.0 (28.5–41.0)	34.0 (30.0–41.0)	.857
Overall transport time (min), median (I quartile - III quartile)	102.5 (90.5–121.2)	91.0 (79.0–110.0)	.029
Interventions during the transport, n. (%)
Intravenous therapy	16 (47.1)	26 (26.2)	.024
Oxygen therapy	18 (52.9)	49 (49.5)	.729
CPAP	15 (44.1)	51 (51.5)	.457
Invasive ventilation	9 (26.5)	8 (8.1)	.006
LOS in NICU (days), median (I quartile - III quartile)	18.0 (13.0–27.7)	8.0 (6.0–12.0)	<.001
LOS in NICU < 72 h, n. (%)	2 (5.9)	9 (9.1)	.343
Death, n. (%)	2 (5.9)	0 (-)	<.001

GA: gestational age; NICU: neonatal intensive care unit; CPAP: continuous positive airway pressure; LOS: length of stay.

^aTime lag between initial emergency call and arrival of the transport team at the patient’s bedside.

^bDemographic data were obtained from governmental sources (ISTAT: Istituto Nazionale di Statistica – the Italian Statistics Institute, available at http://www.istat.it/).