{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:57:44Z","timestamp":1790686664863,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To characterise the aetiology, retrieval characteristics and outcomes of neonatal hyperammonaemia in a statewide neonatal retrieval service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective chart review of all neonates (aged \u2264\u20098\u2009weeks) retrieved by the statewide Paediatric Infant Perinatal Emergency Retrieval (PIPER) service to the Royal Children's Hospital (RCH), Melbourne, Australia, between April 2016 and February 2025, with a pre\u2010transport plasma ammonia &gt;\u2009100\u2009\u03bcmol\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010one neonates met inclusion criteria. Median gestation was 38\u2009weeks (IQR: 38\u201339) and median age at retrieval referral was 59\u2009h (IQR: 48\u201384). A confirmed inborn error of metabolism (IEM) was identified in 16 of 21 neonates (76%), with urea cycle disorders accounting for 12 of the 16 confirmed IEMs (75%). Twelve patients (57%) required continuous veno\u2010venous haemofiltration (CVVHF). Compared with those managed without haemofiltration, the CVVHF group had higher peak ammonia (median 854 vs. 378\u2009\u03bcmol\/L) and a higher rate of confirmed IEM (92% vs. 56%). Twelve retrievals (57%) were classified as time\u2010critical, and metabolic medication was administered during transport in nine cases (43%). Median time from decision to retrieve to team dispatch was 20\u2009min (IQR: 13\u201326) and to specialist hospital arrival 152\u2009min (IQR: 97\u2013229). Seventeen neonates (81%) survived to hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neonatal hyperammonaemia requiring retrieval is predominantly caused by an IEM and frequently requires CVVHF, with low occurrence of spurious elevation. These findings support early retrieval to a quaternary centre with haemofiltration capability and provide benchmarking data for retrieval services managing this rare, high\u2010acuity condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70619","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:16:37Z","timestamp":1790684197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hyperammonaemia in Neonatal Transport: A Retrospective Statewide Review of Neonates Retrieved With Elevated Ammonia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7817-1833","authenticated-orcid":false,"given":"Jessica","family":"Sabljak","sequence":"first","affiliation":[{"name":"Paediatric Infant Perinatal Emergency Retrieval (PIPER) Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2235-4814","authenticated-orcid":false,"given":"Michael","family":"Stewart","sequence":"additional","affiliation":[{"name":"Paediatric Infant Perinatal Emergency Retrieval (PIPER) Royal Children's Hospital  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"},{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1474-2296","authenticated-orcid":false,"given":"Gregory","family":"Woodhead","sequence":"additional","affiliation":[{"name":"Paediatric Infant Perinatal Emergency Retrieval (PIPER) Royal Children's Hospital  Parkville Victoria Australia"},{"name":"NSW Genetic Metabolic Disorders Service Sydney Children's Hospital Network  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9195-1815","authenticated-orcid":false,"given":"Rosalynn","family":"Pszczola","sequence":"additional","affiliation":[{"name":"Paediatric Infant Perinatal Emergency Retrieval (PIPER) Royal Children's Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/0009-8981(84)90135-9","article-title":"Plasma Ammonia Concentrations in Newborns and Children","volume":"138","author":"Colombo J. 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