Journal of paediatrics and child health
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J Paediatr Child Health · Jun 2015
Long-distance transport of neonates with transposition of the great arteries for the arterial switch operation: A 26-year Western Australian experience.
There is evidence that outcomes of complex paediatric cardiac procedures including the arterial switch operation (ASO) for transposition of the great arteries (TGA) are improved when performed at higher volume centres. While in utero transport for surgery is considered ideal, antenatal detection rates of TGA are low. Long-distance transport of post-natally diagnosed neonates has the potential to destabilise the patient's clinical condition. Since 1986, many neonates with TGA have been transported interstate from Perth to Melbourne or Brisbane for ASO surgery. The aim of this study was to review the Western Australian experience of interstate transport of newborns with TGA for ASO, noting transport complications and comparing the early mortality of these patients with published outcomes of the ASO from Royal Children's Hospital (RCH), Melbourne. ⋯ When in utero transport is not possible, long-distance transport of neonates with TGA can be safely undertaken, with no evidence of increased transport mortality/ major morbidity or higher early surgical mortality.
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J Paediatr Child Health · May 2015
Comparing CRIB-II and SNAPPE-II as mortality predictors for very preterm infants.
This article compares the severity of illness scoring systems clinical risk index for babies (CRIB)-II and score for neonatal acute physiology with perinatal extension (SNAPPE)-II for discriminatory ability and goodness of fit in the same cohort of babies of less than 32 weeks gestation and aims to provide validation in the Australian population. ⋯ Both severity of illness scores are ascertained during the first 12 h of life and perform similarly. Both can facilitate risk-adjusted comparisons of mortality and quality of care after the first post-natal 12 h. CRIB-II scores have the advantage of being simpler to collect and calculate.