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Stabilization, respiratory care and survival of extremely low birth weight infants transferred on the first day of life

Journal of Perinatology volume 45, pages 500–505 (2025)Cite this article

Subjects

Abstract

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 FiO2 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.

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Fig. 1: Clinical and transport characteristics of ELBW infants transferred on the first day of life.
Fig. 2: Blood gases performed before and after the transport of ELBW infants.

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Data availability

Datasets generated during the current study are available from the corresponding author on reasonable request. Analysis steps can be accessed via GitHub code repository at https://github.com/belteki/transport_ELBW.

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Acknowledgements

We thank to Rainer Kühner (Vyaire) for help with exporting data from the fabian +nCPAP evolution™ and fabian HFO ventilators. We thank to Miklos Szabo (Semmelweis University, Budapest, Hungary) for sharing national statistics on ELBW infants.

Author information

Authors and Affiliations

  1. Division of Neonatology, Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest, Hungary

    Vera Balog, Andrea Valek & Agnes Jermendy

  2. Neonatal Emergency & Transport Services of the Peter Cerny Foundation, Budapest, Hungary

    Lajos Lantos & Zsolt Somogyvari

  3. Neonatal Intensive Care Unit, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    Gusztav Belteki

Authors
  1. Vera Balog
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  2. Lajos Lantos
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  3. Andrea Valek
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  4. Agnes Jermendy
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  5. Zsolt Somogyvari
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  6. Gusztav Belteki
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Contributions

VB participated in the conception of the study, collected clinical information, participated in interpretation of results, and edited the manuscript. LL participated in acquisition and interpretation of clinical data and revising the article. AV participated in interpretation of clinical data. AJ participated in interpretation of clinical data and revising the article. ZsS participated ins interpretation of clinical data and revising the article. GB was responsible for the conception of the study, the outline of statistical analysis and interpretation of data, and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gusztav Belteki.

Ethics declarations

Competing interests

GB is a consultant to Vyaire Medical (Mettawa, IL, US) and Dräger Medical (Lübeck, Germany). Vyaire Medical did not participate in this research and did not provide any payment for it. The other authors declare no conflict of interest.

Ethics approval

The study was approved by the Scientific and Medical Research Council Ethics Committee of Hungary (reference: 40158-2/2018/EKU). Parental consent was waived. The study was performed in accordance with the Declaration of Helsinki.

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Balog, V., Lantos, L., Valek, A. et al. Stabilization, respiratory care and survival of extremely low birth weight infants transferred on the first day of life. J Perinatol 45, 500–505 (2025). https://doi.org/10.1038/s41372-024-02043-w

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