Impact of transport quality on neonatal clinical stability: use of TRIPS II

Authors

DOI:

https://doi.org/10.61708/4g7yje81

Keywords:

patient transport, neonatology, perinatal care, child health services

Abstract

Introduction: Neonatal transport is a critical time for newborns requiring specialized care. The quality of this transport can significantly determine prognosis and survival. This study evaluated the quality of neonatal transport using the TRIPS II index to determine its impact on clinical stability and early mortality. 
Methodology: A prospective observational cohort-correlational study with longitudinal design was performed. We analyzed 130 newborns admitted to a national reference hospital between June and August 2024, transferred from type A (hospitals with limited resources) and type B (hospitals with complete resources) institutions. The TRIPS II index was used to assess physiological stability at admission and at 12 hours. Neonatal variables, transport factors and institutional resources were analyzed, calculating odds ratios (OR) with 95% confidence intervals. 
Results: Incomplete human and material resources showed significant inverse associations (OR: 3.03; 95% CI: 0.46-3.14). Variables such as weight ≤1500g (OR: 1.58; 95% CI: 0.495-5.038) and gestational age <30 weeks (OR: 1.8; 95% CI: 0.529-6.129) lost statistical significance after 12 hours in the NICU. Neonates with TRIPS II score ≥20 at admission had a higher risk of mortality (OR: 2.08), increasing significantly when this score persisted at 12 hours (OR: 7.81). Type A institutions presented significantly higher TRIPS II scores at admission (20.87±11.32 vs. 14.23±9.43 in type B). 
Conclusions: The TRIPS II index is an effective predictor of neonatal mortality, especially when high scores persist after 12 hours of admission. The availability of human and material resources during transport significantly influences the clinical stability of the neonate.

Downloads

Download data is not yet available.

Author Biographies

  • Gema Elizabeth Arteaga Vergara, Catholic University of Santiago de Guayaquil

    Postgradista de Neonatología, Escuela de graduados, Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador.

  • Carolina Rocío Bello Vinueza, Catholic University of Santiago de Guayaquil

    Postgradista de Neonatología, Escuela de graduados, Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador.

  • Aminda Karina Figueroa González, Catholic University of Santiago de Guayaquil

    Docente de Neonatología, Escuela de graduados, Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador.

  • Sara María Maldonado Vivanco, Catholic University of Santiago de Guayaquil

    Docente de Neonatología, Escuela de graduados, Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador.

References

Elfarargy MS, Alruwaili TA, Elbadry DH, Ahmad AR. Neonatal Transport Program Overview. Journal of Clinical Neonatology. septiembre de 2024;13(3):110. https://doi.org/10.4103/jcn.jcn_23_24 DOI: https://doi.org/10.4103/jcn.jcn_23_24

Balbino AC, Cardoso MVLML, Queiroz MVO. Planejamento do transporte neonatal: percepção das equipes do serviço de atendimento móvel de urgência. Enferm foco (Brasília). 2019;76-82. https://doi.org/10.21675/2357-707X.2019.v10.n2.1812 DOI: https://doi.org/10.21675/2357-707X.2019.v10.n2.1812

Jordán Lucas R, Boix H, Sánchez García L, Cernada M, de las Cuevas I, Couce ML. Recomendaciones sobre el perfil de competencias y estándares del sistema de traslado neonatal en España. Anales de Pediatría. el 1 de junio de 2021;94(6): 420. e1-420.e11. https://doi.org/10.1016/j.anpedi.2021.02.004 DOI: https://doi.org/10.1016/j.anpedi.2021.02.004

Millán García del Real N, Sánchez García L, Ballestero Diez Y, Rodríguez Merlo R, Salas Ballestín A, Jordán Lucas R, et al. Importancia del transporte pediátrico y neonatal especializado. Situación actual en España: Hacia un futuro más equitativo y universal. Anales de Pediatría. el 1 de diciembre de 2021;95(6):485.e1-485.e10. https://doi.org/10.1016/j.anpedi.2021.06.011 DOI: https://doi.org/10.1016/j.anpedi.2021.06.011

Araújo BF, Zatti H, Oliveira Filho PF, Coelho MB, Olmi FB, Guaresi TB, et al. Influência do local de nascimento e do transporte sobre a morbimortalidade de recém-nascidos prematuros. J Pediatr (Rio J). junio de 2011; 87:257-62.

Kirby MAP, Palacios JBP, Alvarado VFO. Evaluación de los Cuidados Obstétricos y Neonatales de Emergencia en un Hospital Base del Sistema Nacional de Salud del Ecuador. REVISTA MÉDICA HJCA. el 1 de marzo de 2015;7(1):45- 7. https://doi.org/10.14410/2015.7.1.ao.09 DOI: https://doi.org/10.14410/2015.7.1.ao.09

Molina AEA, Guerra SSR, Espín IGD, Maldonado D. Determinantes de la supervivencia neonatal entre los neonatos fallecidos entre 2014 a 2017 en Ecuador: Un estudio análisis de bases de datos nacionales. Revista Ecuatoriana de Pediatría. el 22 de abril de 2022;23(1):41-50. https://doi.org/10.52011/148 DOI: https://doi.org/10.52011/148

Davidson LA, Carlisle M, Utarnachitt R, Avaiusini L, Bridges E. Utilizing the Transport Risk Index of Physiologic Stability Version Ii (trips Ii): Establishing a Baseline of the Neonates Transported by Airlift Northwest. Pediatrics. el 1 de enero de 2018;141(1_MeetingAbstract):738. https://doi.org/10.1542/peds.141.1MA8.738 DOI: https://doi.org/10.1542/peds.141.1MA8.738

Duran SR, Aggarwal S, Natarajan G. The effect of transport on the physiologic stability of neonates with ductal-dependent single- ventricle lesions. The Journal of Maternal-Fetal & Neonatal Medicine. el 16 de febrero de 2018;31(4):500-5. https://doi.org/10.1080/14767058.2017.1289164 DOI: https://doi.org/10.1080/14767058.2017.1289164

Lee SK, Zupancic JA, Pendray M, Thiessen P, Schmidt B, Whyte R, et al. Transport risk index of physiologic stability: a practical system for assessing infant transport care. J Pediatr. agosto de 2001;139(2):220-6. https://doi.org/10.1067/mpd.2001.115576 DOI: https://doi.org/10.1067/mpd.2001.115576

Silva PSL da, Aguiar VE de, Reis ME. Assessing Outcome in Interhospital Infant Transport: The Transport Risk Index of Physiologic Stability Score at Admission. American Journal of Perinatology. el 11 de abril de 2012; 29:509-14.

Luna-Hernández G, Varela-Cardoso M, Palacios-Blanco JC. Utilidad de un índice de estabilidad fisiológica basado en TRIPS (Transport Risk Index of Physiologic Stability) para la evaluación de neonatos trasladados a un hospital de concentración. Bol Med Hosp Infant Mex. el 1 de enero de 2015;72(1):45-54. https://doi.org/10.1016/j.bmhimx.2015.01.008 DOI: https://doi.org/10.1016/j.bmhimx.2015.01.008

Karlsen K. The S.T.A.B.L.E program Cuidados Post-reanimación y Pre-Transporte para Neonatos Enfermos Guía para Personal de Salud Neonatal. Manual del estudiante. 5ta ed. Park City: March of Dimes; 2006.

Klemme M, Staffler A, Förster KM, Kappeler J, Flemmer AW. Transport of neonates with respiratory failure: A retrospective quality analysis. Notfall und Rettungsmedizin. 2023;26(3):211-7. https://doi.org/10.1007/s10049-021-00927-4 DOI: https://doi.org/10.1007/s10049-021-00927-4

Downloads

Published

2025-05-30

Issue

Section

Original article

How to Cite

1.
Arteaga Vergara GE, Bello Vinueza CR, Figueroa González AK, Maldonado Vivanco SM. Impact of transport quality on neonatal clinical stability: use of TRIPS II. Gac Med JBG [Internet]. 2025 May 30 [cited 2026 Mar. 7];3(1):27-33. Available from: https://gacetamedicajbgmedec.biteca.online/index.php/GMJBG/article/view/49
Crossref Cited-by logo