Analysis of current situations of neonatal emergency transport system in Yibin City

Objective To explore the current situations of neonatal emergency transport system (NETS) in Yibin, Sichuan Province. Methods A total of 1 184 neonates with critical illness transferred into Department of Neonatology, First People′s Hospital of Yibin by NETS from January 2015 to December 2016 were chosen as study subjects. They were divided into two groups according to the year transferred into Department of Neonatology by NETS: 2015 year group (n=645) and 2016 year group (n=539), respectively. The general clinical data, composition of diseases (classified according to the result of first diagnosis at the time of admission), referral hospitals, referral distance and time, strateges of hospitalization treatment, duration of hospital stay, hospitalization expenses, and outcomes of all neonates were retrospectively analyzed. The referral distance and time of two groups were compared by independent samples t test. The durations of oxygen therapy, nasal continuous positive airway pressure (nCPAP) and tracheal cannula mechanical ventilation, duration of hospital stay, hospitalization expenses between two groups were compared by Wilcoxon rank sum test. The constituent ratios of day-age at the time of admission by NETS and referral hospitals, rates of oxygen therapy, nCPAP and tracheal cannula mechanical ventilation between two groups were compared by chi-square test. This study was approved by the Ethics Committee of Human Beings in First People′s Hospital of Yibin and guardians of every subject signed informed consent of clinical research. There were no statistical differences between two groups in constituent ratios of gender, gestational age and birth weight (P>0.05). Results ①From January 2015 to December 2016, a total of 1 184 neonates with critical illness were transferred into our hospital by NETS, and none of them died during transfer process. ②The ratio of neonates transferred into our hospital by NETS within 24 h after birth in 2016 year group was 81.1% (437/1 184), which was higher than that in 2015 year group 71.2% (459/1 184), and the difference was statistically significant (χ2=15.676, P 0.05). ⑤Among 1 184 neonates with critical illness transferred by NETS in this study, 393 neonates (33.2%, 393/1 184) were given oxygen therapy, 158 neonates 13.3% (158/1 184) were given nCPAP treatment, and 182 neonates 15.4% (182/1 184) were given tracheal cannula mechanical ventilation. There were no statistical differences between two groups in the rates and durations of oxygen therapy, nCPAP and tracheal cannula mechanical ventilation, duration of hospital stay and cost (P>0.05). ⑥Among 1 184 neonates with critical illness transferred by NETS, rate of cured or improved was 93.7% (1 109/1 184), rate of given up treatment was 3.7% (44/1 184), and 37 neonates 2.6% (37/1 184) were transferred to another high grade hospitals. There was no statistical difference between two groups in the constituent ratio of cured or improved, given up treatment, and transferred to another high grade hospitals (P>0.05). Conclusions The NETS in our hospital is running well now. It has solved the problems of poor equipment and shortage of technological level in primary hospitals in Yibin and surrounding areas. Key words: Critical illness; Pneumonia, neonatal; Hypoxic-ischemic encephalopathy, neonatal; Hyperbilirubinemia, neonatal; Neonatal emergency transport system; Regional; Infant, newborn