YF Cheung, MP Leung, KT Chau, KW Hung, MH Cheung

Abstract

This audit reports on the results of two-way interhospital transport of sick infants with cardiac problems from March 1996 to August 1997, using the T1 Globe-Trotter Neonatal Transport System. There were 33 transfers, of which 21 were retrieval transfers of 22 patients, 9 return transfers and 3 transfers to other hospital. Of the 22 patients retrieved, 50% were in significant heart failure requiring ventilatory support, 27% receiving intravenous prostaglandin E1/2 infusions and 23% with anticipated complications due to labile haemodynamic status. Their median age was 19 days (range 0.5 to 193 days) and median weight 2.91 kg (range 1.15 to 5.3 kg). For retrieval transfers by ground transport, the total travel and stabilization time were 88±41 minutes and 57±23 minutes respectively; the average total transport time being 2.4 hours. The single retrieval transfer by air took 2.3 hours in total. There were no equipment failures. Comparison of the pre- and post-transport haemodynamic parameters revealed no significant deterioration. Two-way interhospital transport of paediatric cardiac patients ensures smooth transfer of these high risk patients, and prevents the significant acidosis and hypothermia noted in previous one-way transfer of ventilated patients.

本文報告了1996年3月至1997年8月間，採用T1 Globe-Trotter新生兒轉運系統對心臟病患兒進行醫院間雙向轉送的情況。總共轉運33次，其中挽救21次(22人)，返回原醫院9次，剩下3次是轉往其它醫院。為挽救而轉運的22人中：50%有明顯的心衰表現，需輔助通氣；27%曾靜脈內用前列腺素E 1/2；23%合併可預期的由於血液動力學狀態不穩定而產生的合併症。他們的平均年齡是19天(範圍在0.5至193天之間)，平均體重2.91公斤(範圍是1.15至5.3公斤)。在陸路挽救轉運中，總的運送及穩定時間分別是88 ± 41分鐘及57 ± 33分鐘；平均總的轉運時間是2.4小時。僅有的一例空中挽救轉運用了2.3小時。設備狀況良好。轉運前，後血液動力學指標無明顯惡化。醫院間雙向兒科心臟病患兒轉運保証了這些高危患兒的轉移順暢進行，防止了在單向轉運過程中輔助通氣患兒發生過的酸中毒及體溫降低。