OBJECTIVE: To assess stabilization, respiratory care and survival of extremely low
birth weight (ELBW, <1000 g at birth) infants requiring emergency transfer to tertiary
NICUs on the first day of life. STUDY DESIGN: Retrospective cohort study of 55 ELBW
infants transported by a dedicated neonatal transport service over a 65-month period.
Ventilator data were downloaded computationally. RESULTS: 95% of infants were intubated
and received surfactant prior to transfer. Median expired tidal volume was 5.0 mL/kg
(interquartile range: 4.6-6.2 mL/kg). Infants ventilated with SIPPV had significantly
higher mean airway pressure and minute ventilation, but similar FiO(2) compared to
babies on SIMV. Blood gases showed significant improvement during transport. 55% of
infants survived to discharge from NICU. CONCLUSION: Most ELBW infants transferred
on the first day of life require mechanical ventilation and can be ventilated with
5 mL/kg tidal volume.
