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Do infants with transposition of the great arteries born outside a specialist centre have different outcomes?

Published online by Cambridge University Press:  05 July 2019

Colin Veal ,
Richard Hunt  and
Lyvonne N. Tume
Colin Veal*
Affiliation:
Children’s Critical Care, Wales and West Acute Transport for Children, Bristol, BS2 0TZ, UK
Richard Hunt
Affiliation:
Anaesthetics, University Hospitals Plymouth, Plymouth, UK
Lyvonne N. Tume
Affiliation:
Faculty of Health and Applied Sciences, University of West of England, Bristol, UK
*
Author for correspondence: C. Veal, RN BSc, Advanced Transport Nurse Practitioner, Children’s Critical Care, Wales and West Acute Transport for Children, Jacwyn House, 1 Kings Park Avenue, St Phillips, Bristol, BS2 0TZ, UK. Tel: +44 07950793934; E-mail: Colin.veal@uhbristol.nhs.uk
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Abstract

Background:

Infants born with undiagnosed transposition of the great arteries continue to be born in district general hospitals despite the improvements made in antenatal scanning. Evidence indicates improved outcomes with early definitive treatment after birth, hence the recommendation of delivery in a tertiary centre. The role of specialist paediatric and neonatal transport teams, to advise, stabilise, and transport the infants to a tertiary centre in a timely manner, is critical for those infants born in a district general hospital. This pilot study aims to compare outcomes between infants born in district general hospitals and those who were born in a tertiary maternity unit in South West England and South Wales.

Methods:

This was a secondary data analysis of data collected from the local Paediatric Intensive Care Audit Network and the local transport database. Infants born with a confirmed diagnosis of transposition of the great arteries, that required an arterial switch operation as the definitive procedure between April, 2012 and March 2018 were included.

Results:

Forty-five infants with a confirmed diagnosis of transposition of the great arteries were included. Statistical analysis demonstrated there were no significant differences in the time to balloon atrial septostomy (p = 0.095), time to arterial switch operation (p = 0.461), length of paediatric ICU stay (p = 0.353), and hospital stay (p = 0.095) or mortality between the two groups.

Conclusions:

We found no significant differences in outcomes between infants delivered outside the specialist centre, who were transferred in by a specialist team.

Keywords

Paediatricneonatalnewbornballoon atrial septostomyspecialist retrievaltransportarterial switch operation
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 8 , August 2019 , pp. 1030 - 1035
Copyright
© Cambridge University Press 2019 

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