PC.46 PDA “away days” – service review of the transport process and clinical outcome

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Abstract

Background

The CenTre transport team transfer infants requiring surgical ligation of patent ductus arteriosus (PDA) to specialist paediatric cardiac hospitals, stay with the baby during surgery, assess the baby carefully post-operatively to ensure stability and transfer infants back to the referring unit.1

Aims and Method

We reviewed the case notes and transport records of a cohort of infants undergoing this procedure on a separate hospital site within the same trust. The aim was to describe transport logistics, intensive care support pre and postoperatively and final outcome.

Results

The cohort comprised of 20 patients with median gestation at birth, age at surgery and weight being 28 weeks, 29 days and 1.33 Kg respectively. The median transfer duration and stabilisation times were 8 hrs 50 mins and 1 hr 50 mins respectively.

Results

Ventilator support pre-and post-operatively is shown in Table 1 (median values). Median days to extubation was 7. Post operatively, 5 infants required inotropes and 9 infants required steroids to wean off CPAP. 18 babies were discharged home, 8 required home oxygen and 1 required home NIPPV. 2 babies died, one of these was due to severe respiratory failure in the first 24 h post-operatively.

Conclusions

PDA ligation ‘away days’ have significant clinical and resource implications on the transfer team. There was no significant difference between pre and postoperative intensive care support.

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