Tone Solvik-Olsen, Marit Bekkevold, Fridtjof Heyerdahl, Astri Maria Lang, Jostein S Hagemo, Marius Rehn
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引用次数: 0
Abstract
Background: Neonatal transport is an essential component of modern neonatal intensive care globally, providing access to advanced treatment while exposing vulnerable neonates to environmental conditions that may increase the risk of physiological instability.
Objective: To systematically review studies measuring environmental exposures, specifically vibration, sound and temperature fluctuations during neonatal transport and to evaluate their impact on clinical parameters in neonates.
Methods: A systematic literature review identified studies reporting environmental factors or clinical data during transport via ground, rotor or fixed-wing air ambulances. The medical databases searched included MEDLINE/PubMed, Embase, the Cochrane database of systematic reviews, Nursing Reference Center Plus, UpToDate and SveMed covering the period from November 2020 to January 2025.
Results: 15 observational studies, 13 prospective and 2 retrospective covering publications from 1992 to 2025 were included. The studies included data on vibration, sound, ambient temperature and a wide range of clinical parameters such as heart rate and heart rate variability, change in clinical behaviour scales and cortisol in saliva reflecting the neonatal condition. Only four articles reported the effect of environmental factors on neonatal physiology.
Conclusions: This review highlights the presence of environmental factors, particularly noise and vibration, during transport and raises concerns about their impact on neonates. Although diverse clinical parameters were documented, the small sample sizes and variability in measurement methods across studies limit the ability to draw definitive conclusions. These observations emphasise the need for standardised monitoring protocols and further research to optimise neonatal transport practices.
背景:新生儿转运是全球现代新生儿重症监护的重要组成部分,它提供了获得先进治疗的机会,同时将脆弱的新生儿暴露在可能增加生理不稳定风险的环境条件下。目的:系统回顾测量环境暴露的研究,特别是新生儿运输过程中的振动、声音和温度波动,并评估它们对新生儿临床参数的影响。方法:系统的文献回顾确定了通过地面、旋翼或固定翼空中救护车运输过程中报告环境因素或临床数据的研究。检索的医学数据库包括MEDLINE/PubMed、Embase、Cochrane系统评价数据库、Nursing Reference Center Plus、UpToDate和SveMed,涵盖时间为2020年11月至2025年1月。结果:纳入了15项观察性研究,13项前瞻性研究和2项回顾性研究,涵盖了1992年至2025年的出版物。这些研究包括振动、声音、环境温度和广泛的临床参数,如心率和心率变异性、临床行为量表的变化以及反映新生儿状况的唾液中的皮质醇。只有四篇文章报道了环境因素对新生儿生理的影响。结论:本综述强调了运输过程中环境因素的存在,特别是噪音和振动,并提出了对其对新生儿影响的担忧。尽管记录了不同的临床参数,但小样本量和不同研究测量方法的可变性限制了得出明确结论的能力。这些观察结果强调需要标准化的监测方案和进一步的研究来优化新生儿运输实践。