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Case Report

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Safety in the neonatal and infant transport system: report on three cases with evidence-based comments on safety during transportation


1University Medical Center Ljubljana Surgical Service Department of Pediatric Surgery and Intensive Therapy Medical Faculty, University of Ljubljana

DOI: 10.22514/SV91.042014.14 Vol.9,Issue 1,April 2014 pp.66-72

Published: 30 April 2014

*Corresponding Author(s): STEFAN GROSEK E-mail:


Infant transport has been carried out in Slovenia since 1976. Applying the principles of safe transport was essential to avoid unexpected exposure of critically ill infants to unnecessary and adverse events. Besides organizational and technical prerequisites for safe transportation, evidence-based clinical knowledge and practical competence are of utmost impor-tance. Furthermore, the ongoing possibility of consulting other colleagues during transportation, choose the optimal form of retrieval of very sick infants, is sometimes needed and preferred. Three different cases are presented here where skilled medical teams decided how to transport critically ill infants, and at what risks and costs. All three transports were succe-ssfully completed with good outcomes despite difficult clinical conditions prior to and during retrieval.


safety, neonatal tran-sport, pneumothorax, prostaglandin infusion, extracorporeal membrane oxygenation

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STEFAN GROSEK. Safety in the neonatal and infant transport system: report on three cases with evidence-based comments on safety during transportation. Signa Vitae. 2014. 9(1);66-72.


1. Grosek S, Mlakar G, Vidmar I, Ihan A, Primozic J. Heart rate and leukocytes after air and ground transportation in artificially ventilated neonates: a prospective observational study. Intensive Care Med 2009;5(1):161-5.

2. Grosek Š. Secondary neonatal and infant transport. In: Primožič J, Grosek Š, eds. XIIth Educational Seminar: Critically ill and injured child: recognition, treatment and transport. Ljubljana: Klinični oddelek za otroško kirurgijo in intenzivno terapijo, Kirurška klinika, Univerzitetni Klinični center. 2008. p. 33-7.

3. Fenton AC, Leslie A, Skeoch CH. Optimising neonatal transfer. Arch Dis Child Fetal Neonatal Ed 2004; 89(3):F215-9.

4. Ratnavel N. Safety and governance issues for neonatal transport services. Early Hum Dev 2009; 85(8):483-6.

5. Trevisanuto D, Doglioni N, Ferrarese P, Vedovato S, Cosmi E, Zanardo V. Neonatal pneumothorax: comparison between neonatal transfers and inborn infants. J Perinat Med 2005; 33(5):449-54.

6. Strife JL, Smith P, Dunbar JS, Steven JM. Chest tube perforation of the lung in premature infants: radiographic recognition. AJR Am J Roentgenol 1983; 141(1):73-5.

7. Litmanovitz I, Carlo WA. Expectant management of pneumothorax in ventilated neonates. Pediatrics 2008;122(5):e975-9. Epub 2008 Oct 13.

8. Baumann MH, Strange C. The clinician's perspective on pneumothorax management. Chest 1997; 112(3):822-8.

9. Barrios C, Tran T, Malinoski D, Lekawa M, Dolich M, Lush S, et al. Successful management of occult pneumothorax without tube thora-costomy despite positive pressure ventilation. Am Surg 2008;74(10):958-61.

10. Jaquiss RD, Imamura M. Management of Ebstein's anomaly and pure tricuspid insufficiency in the neonate. Semin Thorac Cardiovasc Surg 2007;19(3):258-63.

11. Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N. Transporting newborn infants with suspected duct dependent conge-nital heart disease on low-dose prostaglandin E1 without routine mechanical ventilation. Arch Dis Child Fetal Neonatal Ed 2007;92:F117-9. 

12. Meckler GD, Lowe C. To intubate or not to intubate? Transporting infants on prostaglandin E1. Pediatrics 2009;123:e25-30.

13. Ferrarese P, Marra A, Doglioni N, Zanardo V, Trevisanuto D. Routine mechanical ventilation for transferred neonates with duct-dependent congenital heart disease. Arch Dis Child Fetal Neonatal Ed 2007;92:F422.

14. Bouchut JC, Teyssedre S. Lessons from transporting newborn infants with known or suspected congenital heart disease. Paediatr Anaesth 2008;18:679-81.

15. Grošelj Grenc M, Pavčnik Arnol M, Kalan G, Podnar T, Vidmar I. Treatment of neonates with congenital heart defects, who need therapy with Prostaglandin E. Zdrav Vestnik 2012;81; 91-8.

16. Clement KC, Fiser RT, Fiser WP, Chipman CW, Taylor BJ, Heulitt MJ, et al. Single-institution experience with interhospital extracorporeal membrane oxygenation transport: A descriptive study. Pediatr Crit Care Med 2010; 11(4):509-13.

17. Cabrera AG, Prodhan P, Cleves MA, Fiser RT, Schmitz M, Fontenot E, et al. Interhospital transport of children requiring extracorporeal membrane oxygenation support for cardiac dysfunction. Congenit Heart Dis 2011;6(3):202-8. doi: 10.1111/j.1747-0803.2011.00506.x.

18. Wilson BJ Jr, Heiman HS, Butler TJ, Negaard KA, DiGeronimo R. A 16-year neonatal/pediatric extracorporeal membrane oxygenation transport experience. Pediatrics 2002;109(2):189-93.

19. Weber TR, Connors RH, Tracy F, Jr, Bailey PV, Stephens C, Keenan W. Prognostic Determinants in Extracorporeal Membrane Oxygenation for Respiratory Failure in Newborns. Ann Thoruc Surg 1990;50:720-3.

20. Vidmar I, Primožic J, Kalan G, Grosek G. Extracorporeal membranous oxygenation (ECMO) in neonates and children experiences of a multidisciplinary paediatric intensive care unit. Signa Vitae 2008;3 Suppl 1:S17–21.

21. Primožič J, Kalan G, Grosek Š, Vidmar I, Lazar I, Kosin M, et al. Extracorporeal membrane oxygenation-12 years experiences. Zdrav Vestnik 2006;75:61–70.

22. Perreault T. ECMO or no ECMO: Do no harm. An Esp Pediatr 2002;57(1):1-4.

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