Respiratory support settings as indicator of the transportability of newborns

Abstract

Purpose. To evaluate the predictive value of the parameters of respiratory support for newborn patients with respiratory insufficiency in assessing non-transportability.Materials and methods. The observational, cohort, retrospective study included data from 284 trips of the transport team to ventilated newborns from August 1, 2017  to December 31, 2018, a subgroup of transportable patients (n=244) and newborns recognized as untransportable due to the presence of respiratory insufficiency (n=40) was identified. The assessment and comparison of anamnesis, the status at the time of arrival of the transport team, intensive care, the parameters of respiratory support and its correction, monitored parameters, as well as assessments on scales — KSHONN, NTISS and TRIPS.Results. Тhe calculated respiratory parameters have a high predictive value for the non-transportability of newborns: the AUC ROC for the mean airway pressure is 0.858 [0.785–0.931], for the saturation index of oxygenation — 0.931 [0.893–0.970], for the SpO2/FiO2 ratio —  0.937 [0.901–0.973]. These indicators demonstrate significantly higher values of AUC ROC in comparison with the KSHONN scales (AUC=0.812 (0.742–0.882)), NTISS (AUC=0.848 (0.793–0.904)), TRIPS (AUC=0.802 (0.726–0.879)) scales. The high predictor value of the mean airway pressure and the saturation index of oxygenation for nontransportability remains high regardless of the need for catecholamine infusion.Conclusion. Mean airway pressure, saturation oxygenation index and SpO2/FiO2 ratio demonstrate a high predictive value for the patient’s non-transportability, exceeding the accuracy of the scales (KSHONN, NTISS, TRIPS).