Presented at the Neonatal Society 2005 Spring Meeting.

Ofoegbu BN, Clarke P, Turley J, Bowe L, Sidebottom A, Robinson MJ

Regional Neonatal Intensive Care Unit, Hope Hospital, Stott Lane, Salford M6 8HD, UK

Introduction: With the evolution of neonatal networks and dedicated intensive care retrieval systems, earlier back transfer to referring level 2 units could facilitate more efficient use of tertiary level intensive care cots. Use of nasal continuous airway pressure (nCPAP) as a means of respiratory support during neonatal transportation may allow earlier back transfer of nCPAP dependent infants who would otherwise be grounded at tertiary centres.

Aim: To examine the feasibility of nCPAP use for back transfer of nCPAP dependent infants to referral (level 2) hospitals.

Methods: In a prospective study, between July 2003 and October 2004,we have used nCPAP as a means of respiratory support for nCPAP dependent infants during neonatal back transfer to base/home hospitals. Two weeks later, a telephone call was made to all accepting units to ascertain if there had been any significant clinical deterioration following transfer. The study group was compared with an historical cohort of infants who had undergone transfer in the 30 month period prior to July 2003 when nCPAP was not available for neonatal transport, ie, they were at the time of transfer not nCPAP dependent.

Results: We did not experience any significant problems with temperature control. Temperature of baby at receiving unit ranged from 36.5-37.5 degrees Celsius. There were no reports from receiving units of clinical deterioration that could be attributed to the timing or mode of transfer.

Conclusion: Transfer of selected small infants using nCPAP appears to be practicable and safe. This respiratory transport modality is likely to have a beneficial effect on intensive care cot availability.

References
1. J H Simpson, I Ahmed, J McLaren and C H Skeoch. Archives of Disease in Childhood Fetal and Neonatal Edition 2004;89:F374