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Need of mechanical ventilation of infants on prostaglandin E1 during transport
  1. Y Singh1,2,
  2. C Watt2,
  3. S Clark2
  1. 1Bradford Royal Infirmary, Bradford, UK
  2. 2Jessops Wing, Sheffield Teaching Hospitals, Sheffield, UK

Abstract

Background Many babies being transported on prostaglandin E1 infusion for suspected duct dependent congenital heart diseases are ventilated without any evidence of need of routine mechanical ventilation.

Objectives To assess the need of mechanical ventilation during the transport of infants on prostaglandin infusion for suspected congenital heart conditions.

Design and methods Retrospective analysis of all the babies on prostaglandin infusion transported by the North Trent Neonatal transport team between 2006 and 2008.

Results 39 infants were transported on a prostaglandin infusion. Median birth weight was 3.20 kg (IQR=2.43–3.48 kg) and median gestational age was 40 weeks (IQR=37–40 weeks). Out of 39, 6 infants (15%) required ventilation during transport.

Median dose of prostaglandin was 100 ng/kg/min for ventilated infants (IQR: 40 to 100 ng/kg/min) while median dose for non-ventilated infants was 12 ng/kg/min (IQR: 10 to 15 ng/kg/min and p value of 0.009).

None of the infants requiring ≤15 ng/kg/min of prostaglandin were ventilated, although one was on CPAP (p=0.007), while on a dose of >15 nm/kg/min 5 infants required ventilation. This gives a relative risk of ventilation of 11 with 95% CI of 2 to 68 for a dose of prostin over 15 ng/kg/min.

Conclusions None of the infant receiving ≤15 ng/kg/min of prostaglandin E1 infusion required mechanical ventilation during transport. We conclude that there is no need of mechanical ventilation during transport of infants receiving ≤15 n/kg/min of prostaglandin E1. However, it would be sensible to transport these infants with a person competent in airway management.

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