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Improving transport time for babies with antenatally diagnosed transposition of the great arteries reduces the need for ECMO

Journal of Perinatology volume 40, pages 1570–1575 (2020)Cite this article

Subjects

Abstract

Objective

To assess the effect of reducing retrieval team response time on the outcomes of babies born outside a cardiac centre (outborn) with antenatally diagnosed transposition of the great arteries.

Study design

Retrospective cohort study of all outborn babies with antenatally diagnosed TGA anticipated to require transfer for urgent balloon atrial septostomy over a 6-year period (15 babies pre intervention and 27 post intervention). The intervention involved a collaborative multicomponent practice change aiming to reduce retrieval team response time.

Result

The mean (SD) time from birth to cardiac ICU arrival was 159 (12) min pre intervention and 103 (6) min post intervention (mean difference −57 min [95% CI, −81 to −32]). There was a significant decrease in need for extracorporeal membrane oxygenation (33% versus 4%), RR 0.11 [95% CI, 0.02–0.65]), with a number needed to treat of 3.4 to prevent one ECMO episode.

Conclusion

Reducing retrieval time is achievable with collaborative systems, and significantly improves clinical outcomes.

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Authors and Affiliations

  1. Newborn Care Unit, John Radcliffe Hospital, Oxford, UK

    Amir Zayegh

  2. Paediatric Infant and Perinatal Retrieval Service (PIPER), The Royal Children’s Hospital, Melbourne, VIC, Australia

    Michael Stewart

  3. Murdoch Children’s Research Institute, Melbourne, VIC, Australia

    Michael Stewart, Carmel Delzoppo & Bennett Sheridan

  4. Paediatric Intensive Care Unit, The Royal Children’s Hospital, Melbourne, VIC, Australia

    Carmel Delzoppo & Bennett Sheridan

  5. Department of Cardiology, The Royal Children’s Hospital, Melbourne, VIC, Australia

    Bennett Sheridan

Authors
  1. Amir Zayegh
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  2. Michael Stewart
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  3. Carmel Delzoppo
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  4. Bennett Sheridan
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Contributions

AZ acquired patient data, analysed the results, drafted the initial manuscript and approved the final manuscript as submitted. MS conceptualised and designed the study, critically reviewed the manuscript and approved the final manuscript as submitted. CD acquired patient data and approved the final manuscript as submitted. BS conceptualised and designed the study, critically reviewed the manuscript and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Amir Zayegh.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was given ethics approval by the Royal Children’s Hospital Melbourne Human Research Ethics Committee (approval ref LNR/18/RCHM/256).

Patient consent

Parents provided written consent for their children’s data to be stored in PIPER and RCH PICU databases for de-identified research use.

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Zayegh, A., Stewart, M., Delzoppo, C. et al. Improving transport time for babies with antenatally diagnosed transposition of the great arteries reduces the need for ECMO. J Perinatol 40, 1570–1575 (2020). https://doi.org/10.1038/s41372-020-0679-0

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