Impact of neonatal inter-hospital transport

• Research type

  Research Study

• Full title

  The impact of inter-hospital transportation: Neonatal outcomes and implications for families

• IRAS ID

  235380

• Contact name

  Don Sharkey

• Contact email

  don.sharkey@nottingham.ac.uk

• Sponsor organisation

  University of Nottingham

• Duration of Study in the UK

  1 years, 9 months, 17 days

• Research summary

  The number of admissions to UK neonatal units is increasing each year (~90 000 in 2016), resulting in an increased demand on the number of cots available to care for these babies. This often results in the need to transport babies from the place of birth to another unit for specialist care or due to lack of cots (~16,000 transfers/yr). Transportation of infants from the place of birth has been shown to cause the parents psychological distress due to the burden of traveling long distances, financial implications and residing away from their support group and family.

  Although transporting babies from lower service provision centres to intensive care units has decreased mortality, other outcomes such as neurodisability haven't changed. Studies have shown transportation increases the risk of bleeding into the brain, which again can lead to cerebral palsy and learning difficulties and exposes babies to noxious stimuli such as excessive vibration, noise and hypothermia. This exposure could result in increased risk of long-term neurological problems.

  Babies who are deprived of oxygen at birth require treatment to decrease the body temperature to reduce both mortality and neurodisability, which needs to be undertaken at specialist centres. A small study showed babies born outside of specialist centres compared to those inborn, had more severe asphyxia and had delays in starting cooling, but no difference in overall outcomes. This study was limited by the small number of infants included and differences in baseline characteristics between the groups.

  This study aims to:
  - quantify the impact of inter-hospital transfer on babies and their families in terms of time/distance away from their place of residence
  - describe the patterns of inter-hospital transfer around the UK.
  - evaluate the short term outcomes and clinical characteristics of babies who are born within cooling centres to those who are outborn

• REC name

  London - City & East Research Ethics Committee

• REC reference

  17/LO/1822

• Date of REC Opinion

  30 Oct 2017

• REC opinion

  Favourable Opinion