Section on Transport Medicine

The Section on Transport Medicine provides an annual forum for the discussion of clinical matters or research related to the field of pediatric transport medicine. Abstracts and posters are presented during the Section's educational and scientific program at the AAP's National Conference & Exhibition (NCE).

Congratulations to the 2008 winner!!

C ROBERT CHAMBLISS MD BEST PAPER AWARD -- Recognizes the best abstract or poster presentation given during the SOTM education program by a non-student or non-resident transport professional.

NEAR-CONTINUOUS BLOOD PRESSURE (BP) MONITORING DURING TRANPORT IMPROVES OUTCOMES IN PICU PATIENTS: A RANDOMIZED CONTROLLED TRIAL. Michael H Stroud, MD, Presenter
The presenter received a certificate and a $500 honorarium.
Purpose: Frequent, accurate BP monitoring ensures proper care of critically ill pediatric patients during transport. Oscillometric BP devices give intermittent, delayed BP measurements, with inaccuracies due to motion artifact. Accurate, continuous measures of BP may improve care during transport and outcomes of critically ill pediatric patients.
Methods: A randomized controlled trial compared two approaches: intermittent BP measurements using an oscillometric device (OD; Dinamap®) or near-continuous BP measurements using a noninvasive device (NCD; Vasotrac®). Patients aged 1-17 years, meeting age-adjusted criteria for the systemic inflammatory response syndrome (SIRS) or moderate-to-severe head trauma, were randomized to the two groups. We hypothesized that near-continuous BP measurements during transport would reduce length of hospital stay (LOS) compared to intermittent BP measurements.
Results: 710 consecutive transport patients were screened; N=94 were enrolled. 46 patients were monitored with NCD (age 6.7±4.6 yrs [mean±SD]; 70% with SIRS, 30% with head trauma) and 50 patients with OD (age 8.5±5.4 yrs; 68% with SIRS, 32% with head trauma). Severity of illness was comparable (Mean Pediatric Index of Mortality (PIM-II) score 5.4%±5.2% [NCD] versus 4.9%±3.1% [OD], p=0.89. NCD patients received more intravenous fluid (IVF) during transport: 19.7±15.4ml/kg [NCD] versus 7.9±7.9ml/kg [OD], p=0.004. NCD patients required fewer hospital interventions: TISS-28, 17.3±5.7 [NCD] versus 21.0±9.2 [OD], p=0.013. Mean LOS for the NCD group was 6.03±5.04 days versus 11.07±13.7 days for the OD group.
Conclusion: Near-continuous BP monitoring of pediatric patients with SIRS and head trauma during transport is associated with decreased LOS, increased IVF resuscitation, and decreased hospital interventions. Improved BP monitoring may lead to therapeutic interventions in the out-of-hospital setting, resulting in improved outcomes for critically ill pediatric patients.

BEST-IN-TRAINING PAPER -- Recognizes the best abstract or poster presentation given during the SOTM education program by a student, resident, or post-graduate fellow.

Not awarded in 2008