Long-distance transports of newborn infants with congenital heart disease

Little has been published about specific problems that may occur during lon g-distance transports of newborn cardiac patients. During a 4-year period a fter centralization of pediatric heart surgery in Sweden, 286 transports we re prospectively investigated. A majority (77.3%) of the transports were ca rried out by nonspecialized teams. Ten severe adverse events, including the death of I infant, occurred during the 286 transports (3.5%). Another infa nt died later of cerebral complications from hypoxia, rendering a transport -related mortality of 0.7%. Twenty-two infants (7.7%) were severely hypoxic (oxygen saturation less than or equal to 65%) at arrival, and 12 of these infants suffered from transposition of the great arteries. During the secon d 2-year period increased use of intravenous prostaglandin E-1 and transpor tation from tertiary-level units was associated with better transport outco me. During the same time period, overall 30-day postoperative mortality for pediatric cardiac surgery decreased from 4.0% to 1.2% in our hospital. Whe n highly specialized treatment is centralized for quality reasons it is als o important that risks associated with transport are considered and that th e quality of transport is high. For some cardiac malformations antenatal di agnosis and referral of the mother for delivery to a center with pediatric cardiac surgery would probably further increase the chance of healthy survi val in some infants.