European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients

Ulrich Terheggen¹, Christian Heiring², Mattias Kjellberg³, Fredrik Hegardt⁴, Martin Kneyber^{5

6}, Maurizio Gente⁷, Charles C Roehr^{8

9}, Gilles Jourdain¹⁰, Pierre Tissieres^{11

12}, Padmanabhan Ramnarayan^{13

14}, Morten Breindahl², Johannes van den Berg¹⁵

Affiliations

¹ Department of Critical Care, Paediatric and Cardiac Intensive Care Unit, Al Jalila Children's Hospital, Dubai, United Arab Emirates. terheggen@gmx.org.
² Department of Neonatal and Paediatric Intensive Care, Rigshospitalet, the National University Hospital in Denmark, Copenhagen, Denmark.
³ Department of Neonatal Intensive Care, Uppsala University Children's Hospital, Uppsala, Sweden.
⁴ Department of Pediatrics, Neonatal Intensive Care Unit, Umeå University Hospital, Umeå, Sweden.
⁵ Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University, Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁶ Critical Care, Anaesthesiology, Peri-Operative & Emergency Medicine (CAPE), University of Groningen, Groningen, The Netherlands.
⁷ Maternal Infant Department, Policlinico Umberto I, Sapienza University of Roma, Roma, Italy.
⁸ National Perinatal Epidemiology Unit Clinical Trials Unit, Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK.
⁹ Newborn Services, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK.
¹⁰ Division of Pediatrics, Neonatal Critical Care and Transportation, Medical Center "A.Béclère", Paris Saclay University Hospitals, APHP, Paris, France.
¹¹ Pediatric Intensive Care Unit, Bicêtre University Hospital, AP-HP, Paris Saclay University, Le Kremlin-Bicêtre, France.
¹² Integrative Biology of the Cell, CNRS, CEA, Paris South University, Paris Saclay University, Gif-sur-Yvette, France.
¹³ Children's Acute Transport Service (CATS), Great Ormond Street Hospital, London, UK.
¹⁴ Paediatric Intensive Care Unit, St Mary's Hospital, London, UK.
¹⁵ Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

PMID: 32634819
DOI: 10.1038/s41390-020-1050-z

Review

European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients

Ulrich Terheggen et al. Pediatr Res. 2021 Apr.

. 2021 Apr;89(5):1094-1100.

doi: 10.1038/s41390-020-1050-z. Epub 2020 Jul 7.

Authors

Affiliations

¹ Department of Critical Care, Paediatric and Cardiac Intensive Care Unit, Al Jalila Children's Hospital, Dubai, United Arab Emirates. terheggen@gmx.org.
² Department of Neonatal and Paediatric Intensive Care, Rigshospitalet, the National University Hospital in Denmark, Copenhagen, Denmark.
³ Department of Neonatal Intensive Care, Uppsala University Children's Hospital, Uppsala, Sweden.
⁴ Department of Pediatrics, Neonatal Intensive Care Unit, Umeå University Hospital, Umeå, Sweden.
⁵ Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University, Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁶ Critical Care, Anaesthesiology, Peri-Operative & Emergency Medicine (CAPE), University of Groningen, Groningen, The Netherlands.
⁷ Maternal Infant Department, Policlinico Umberto I, Sapienza University of Roma, Roma, Italy.
⁸ National Perinatal Epidemiology Unit Clinical Trials Unit, Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK.
⁹ Newborn Services, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK.
¹⁰ Division of Pediatrics, Neonatal Critical Care and Transportation, Medical Center "A.Béclère", Paris Saclay University Hospitals, APHP, Paris, France.
¹¹ Pediatric Intensive Care Unit, Bicêtre University Hospital, AP-HP, Paris Saclay University, Le Kremlin-Bicêtre, France.
¹² Integrative Biology of the Cell, CNRS, CEA, Paris South University, Paris Saclay University, Gif-sur-Yvette, France.
¹³ Children's Acute Transport Service (CATS), Great Ormond Street Hospital, London, UK.
¹⁴ Paediatric Intensive Care Unit, St Mary's Hospital, London, UK.
¹⁵ Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

PMID: 32634819
DOI: 10.1038/s41390-020-1050-z

Abstract

Background: The 2020 novel coronavirus (SARS-Cov-2) pandemic necessitates tailored recommendations addressing specific procedures for neonatal and paediatric transport of suspected or positive COVID-19 patients. The aim of this consensus statement is to define guidelines for safe clinical care for children needing inter-facility transport while making sure that the clinical teams involved are sufficiently protected from SARS-CoV-2.

Methods: A taskforce, composed of members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Transport section and the European Society for Paediatric Research (ESPR), reviewed the published literature and used a rapid, two-step modified Delphi process to formulate recommendations regarding safety and clinical management during transport of COVID-19 patients.

Results: The joint taskforce consisted of a panel of 12 experts who reached an agreement on a set of 17 recommendations specifying pertinent aspects on neonatal and paediatric COVID-19 patient transport. These included: case definition, personal protective equipment, airway management, equipment and strategies for invasive and non-invasive ventilation, special considerations for incubator and open stretcher transports, parents on transport and decontamination of transport vehicles.

Conclusions: Our consensus recommendations aim to define current best-practice and should help guide transport teams dealing with infants and children with COVID-19 to work safely and effectively.

Impact: We present European consensus recommendations on pertinent measures for transporting infants and children in times of the coronavirus (SARS-Cov-2 /COVID-19) pandemic. A panel of experts reviewed the evidence around transporting infants and children with proven or suspected COVID-19. Specific guidance on aspects of personal protective equipment, airway management and considerations for incubator and open stretcher transports is presented. Based on scant evidence, best-practice recommendations for neonatal and paediatric transport teams are presented, aiming for the protection of teams and patients. We highlight gaps in knowledge and areas of future research.

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References

1. WHO. Coronavirus disease 2019 (COVID-19) Situation Report. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio... (2020).
1. Wu, Z. & McGoogan, J. M. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA 323, 1239–1242 (2020). https://doi.org/10.1001/jama.2020.2648 . - PubMed - DOI
1. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. Vital surveillances: the epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Weekly http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a... (2020).
1. Schoenberg, N. C. et al. A comparative analysis of pulmonary and critical care medicine guideline development methodologies. Am. J. Respir. Crit. Care Med. 196, 621–627 (2017). - PubMed - PMC - DOI
1. Dong, Y. et al. Epidemiology of COVID-19 among children in China. Pediatrics 145, e20200702 (2020). - PubMed - DOI

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European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients

Affiliations

European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous