{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:35:05Z","timestamp":1793226905243,"version":"4.5.0"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951120001420_as1\" sec-type=\"other\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We sought to systematically study determinants of \u201cclinical status at arrival after transport\u201d of neonates with CHD and its impact on clinical outcomes in a low- and middle-income country environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951120001420_as2\" sec-type=\"other\">\n                    <jats:title>Methods and results:<\/jats:title>\n                    <jats:p>Consecutive neonates with CHD (n = 138) transported (median distance 138 km; 5\u2013425 km) to a paediatric cardiac programme in Southern India were studied prospectively. Among 138 neonatal transports, 134 were in ambulances. Four neonates were transported by family in private vehicles; 60% with duct-dependent circulation (n = 57) were transported without prostaglandin E1. Clinical status at arrival after transport was assessed using California modification of TRIPS Score (Ca-TRIPS), evidence of end-organ injury and metabolic insult.<\/jats:p>\n                    <jats:p>Upon arrival, 42% had end-organ injury, 24% had metabolic insult and 36% had Ca-TRIPS Score &gt;25. Prior to surgery or catheter intervention, prolonged ICU stay (&gt;48 hours), prolonged ventilation (&gt;48 hours), blood stream sepsis, and death occurred in 48, 15, 19, and 3.6%, respectively. Ca-TRIPS Score &gt;25 was significantly associated with mortality (p = 0.005), sepsis (p = 0.035), and prolonged ventilation (p &lt; 0.001); end-organ injury with prolonged ICU stay (p = 0.031) and ventilation (p = 0.045); metabolic insult with mortality (p = 0.012) and sepsis (p = 0.015).<\/jats:p>\n                    <jats:p>Fifteen babies needed only medical management, 10 received comfort care (due to severe end-organ injury in 3), 107 underwent cardiac surgery (n = 83) or catheter intervention (n = 24), with a mortality of 6.5%. Clinical status at arrival after transport did not impact post-procedure outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951120001420_as4\" sec-type=\"other\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Neonates with CHD often arrive in suboptimal status after transport in low- and middle-income countries resulting in adverse clinical outcomes. Robust transport systems need to be integrated in plans to develop newborn heart surgery in low- and middle-income countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951120001420","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T04:32:54Z","timestamp":1591677174000},"page":"1001-1008","source":"Crossref","is-referenced-by-count":20,"title":["Impact of transport on arrival status and outcomes in newborns with heart disease: a low\u2013middle-income country perspective"],"prefix":"10.1017","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-2140","authenticated-orcid":false,"given":"Balaganesh","family":"Karmegaraj","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Kappanayil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abish","family":"Sudhakar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4343-0951","authenticated-orcid":false,"given":"Raman Krishna","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"key":"S1047951120001420_ref27","doi-asserted-by":"publisher","DOI":"10.1159\/000239769"},{"key":"S1047951120001420_ref5","first-page":"646","article-title":"Effectiveness of neonatal transport","volume":"118","author":"Gunn","year":"1978","journal-title":"Can Med Assoc J"},{"key":"S1047951120001420_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0095-5108(18)31139-4"},{"key":"S1047951120001420_ref36","first-page":"A14666","article-title":"Relative impact of congenital heart disease on mortality in infancy around the globe: the global burden of disease study","volume":"136","author":"Zimmerman","year":"2017","journal-title":"Circulation"},{"key":"S1047951120001420_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12742"},{"key":"S1047951120001420_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-1890-0"},{"key":"S1047951120001420_ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1533-y"},{"key":"S1047951120001420_ref19","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2013-028"},{"key":"S1047951120001420_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-693X(97)87234-X"},{"key":"S1047951120001420_ref25","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2015.09.008"},{"key":"S1047951120001420_ref2","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1987.15.6.515"},{"key":"S1047951120001420_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951117002608"},{"key":"S1047951120001420_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12066"},{"key":"S1047951120001420_ref31","unstructured":"31. World Health Organization. Hypoglycemia of the Newborn: Review of the Literature. World Health Organization, Geneva, 1997. Retrieved August 1, 2018, from http:\/\/www.who.int\/child_adolescent_health\/documents\/chd_97_1\/en\/index.html"},{"key":"S1047951120001420_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-013-2231-0"},{"key":"S1047951120001420_ref34","unstructured":"34. Attaining Millennium development goals in India. Infant and child mortality. Retrieved August 17, 2012, from http:\/\/www.mospi.gov.in\/sites\/default\/files\/publication_reports\/MDG_Final_Country_report_of_India_27nov17.pdf"},{"key":"S1047951120001420_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-991X(05)80148-8"},{"key":"S1047951120001420_ref24","first-page":"304","article-title":"Risk factors associated to clinical deterioration during the transport of sick newborn infants","volume":"110","author":"Goldsmit","year":"2012","journal-title":"Arch Argent Pediatr"},{"key":"S1047951120001420_ref14","first-page":"213","article-title":"Prototype expert system to assist with the stabilization of neonates prior to transport","author":"Heermann","year":"1997","journal-title":"Proc AMIA Annu Fall Symp"},{"key":"S1047951120001420_ref1","doi-asserted-by":"publisher","DOI":"10.7748\/paed.20.1.20.s20"},{"key":"S1047951120001420_ref3","first-page":"801","article-title":"The transport of neonates to an intensive care unit","volume":"84","author":"Pieper","year":"1994","journal-title":"S Afr Med J"},{"key":"S1047951120001420_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2003.08.007"},{"key":"S1047951120001420_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2002.019711"},{"key":"S1047951120001420_ref8","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.57"},{"key":"S1047951120001420_ref9","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2003-0960-L"},{"key":"S1047951120001420_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200208000-00010"},{"key":"S1047951120001420_ref12","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.115576"},{"key":"S1047951120001420_ref16","first-page":"288","article-title":"Regionalization of infant transports: the southern California experience and its implications. 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