{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:19:30Z","timestamp":1789474770989,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T00:00:00Z","timestamp":1636502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Bilious vomiting (BV) in the neonatal period may herald malrotation with life\u2010threatening volvulus. In New South Wales, contrast fluoroscopy is not available in non\u2010tertiary paediatric centres; therefore, transfer is required. An infant with BV referred to Newborn and Paediatric Emergency Transport Service is prioritised for urgent retrieval to a surgical centre for contrast fluoroscopy and paediatric surgical review. This study analysed how many neonates with BV needed retrieval to prevent bowel loss or to save one life and to identify predictors of malrotation and\/or volvulus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All neonatal referrals (&lt;29\u2009days) to Newborn and Paediatric Emergency Transport Service between 31 July 2014 and 31 July 2020 with BV or aspirates were examined. Data on time of onset of BV, time of call for retrieval, vital signs, lactate level and blood glucose at referral, time of arrival at the surgical centre and outcome were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 391 neonates referred with BV, 113 (28.9%) had a surgical cause and 31 (7.9%) had a time\u2010critical malrotation and\/or volvulus. All 31 neonates were well at referral with normal vital signs including three neonates who subsequently died. Lactate levels at referral (1\u20137.5\u2009mmol\/L) were not predictive of outcome. The odds of a time\u2010critical diagnosis increased with every day of age (odds ratio\u00a0=\u00a01.097), heart rate &gt;140 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.04) and decreased for each kilogram of birthweight (odds ratio 0.475; confidence interval 0.294\u20130.768).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neonates with BV require urgent referral to paediatric surgery and contrast fluoroscopy. Thirteen urgent transfers are required to preserve the bowel integrity and life in one baby.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15829","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T12:36:38Z","timestamp":1636547798000},"page":"774-781","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["How should the neonatal retrieval team respond to the neonate referred with bilious vomiting?"],"prefix":"10.1111","volume":"58","author":[{"given":"Sunaina","family":"Nundeekasen","sequence":"first","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Dalrymple","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"},{"name":"Grace Centre for Newborn Intensive Care Children's Hospital Westmead  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Moustafa","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"},{"name":"Grace Centre for Newborn Intensive Care Children's Hospital Westmead  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Thomas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Surgery Children's Hospital Westmead  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn Browning","family":"Carmo","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service  Sydney New South Wales Australia"},{"name":"Grace Centre for Newborn Intensive Care Children's Hospital Westmead  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.32909"},{"key":"e_1_2_9_3_1","first-page":"2791","article-title":"Bilious vomiting in the newborn: Rapid diagnosis of intestinal obstruction","volume":"61","author":"Kimura K","year":"2000","journal-title":"Am. 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