新生児における空路搬送の安全性、速達性、その効果

• Material Type: 博士論文
• Title: 新生児における空路搬送の安全性、速達性、その効果
• Author/Editor: 平川, 英司
• Author Heading: 平川, 英司 ヒラカワ, エイジ
• Publication, Distribution, etc.: Japan Pediatric Society
• Alternative Title: Safety, speed, and effectiveness of air transportation for neonates.
• Degree grantor/type: 鹿児島大学
• Date Granted: 2020-09-30
• Dissertation Number: 甲総研第575号
• Degree Type: 博士(医学); Doctor of Philosophy in Medical Science
• Text Language Code: eng
• Subject Heading: neonatal air transportation; obstetrics clinic; Rapid Response Team; resuscitation; SNAPPE-II
• Target Audience: 一般
• Note (General): 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨; Background : In Japan, 44.3% of neonates are delivered in private clinics without an attending pediatrician. Obstetricians in the clinics must resuscitate asphyxiated neonates in unstable condition, such as respiratory failure, and they are frequently transferred to tertiary perinatal medical centers. There has been no study comparing the physiological status and prognosis of neonates transported by ambulance with those transported by helicopter. Methods: Medical and transport records were used to compare the physiological status of neonates transported to Kagoshima City Hospital by land and those transported by air between January 1, 2013, and December 31, 2017. Results : Data from 425 neonates transferred by land and 143 by air were analyzed. There were no significant differences between the two groups in mean gestational age, mean birthweight, fetal blood pH, Apgar score, or the Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II) on arrival to the tertiary center (16.3 ± 15.4 [95% confidence interval (CI): 13.2–17.7] vs 16.4 ± 15.4 [95% CI: 13.9–19.0], respectively; P = 0.999); both groups had SNAPPE-II score 10–19, indicating no difference in mortality risk. The times to starting first aid and to admission to the intensive care unit were significantly reduced in neonates transported by air than by land. In subgroup analysis of patients of a gestational age ≤28 weeks, all cases of severe intraventricular hemorrhage (IVH) were observed in the land transportation group. Conclusions: Neonatal transportation by air is as safe as land transportation, and time to first aid and intensive care are significantly reduced by transportation by air than by land. Air transport could also contribute to the prevention of IVH in neonatal transportation. This is the peer reviewed version of the following article: Eiji Hirakawa, Satoshi Ibara, Hideaki Yoshihara, Masato Kamitomo, Yuichi Kodaira, Masaya Kibe, Chie Ishihara, Yoshiki Naito, Masakatsu Yamamoto, Tsuyoshi Yamamoto, Tatsu Takayama, Tomonori Kurimoto, Yuta Mikami, Hiroshi Ohashi. Safety, speed, and effectiveness of air transportation for neonates Pediatrics international (2021), 63(4), 415-422 © 2020 Japan Pediatric Society which has been published in final form at https://doi.org/10.1111/ped.14401 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
• Format (IMT): application/pdf
• Source: Diss_平川_英司_ISK575_2020 （fulltext）; https://ir.kagoshima-u.ac.jp/record/15484/files/Diss_%E5%B9%B3%E5%B7%9D_%E8%8B%B1%E5%8F%B8_ISK575_2020.pdf
• Access Restrictions: インターネット公開
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 鹿児島大学 : 鹿児島大学リポジトリ