PRESERVED INFLAMMATORY HOMEOSTASIS DURING EMERGENCY TRANSPORT: A MULTIBIOMARKER ASSESSMENT OF NEONATAL RDS TRANSFERS

Eyüp SARI, Şerife Suna OĞUZ, Mehmet Semih DEMİRTAŞ, Bensu BULUT, Medine AKKAN ÖZ, Murat GENÇ, Ayşenur GÜR, Ümit Alper ÖZCAN, Hüseyin MUTLU, Ramiz YAZICI

Turkish Journal of Medical Sciences - 2026;56(4):1105-1112

Department of Paediatrics, Gülhane Training and Research Hospital, Ankara, Turkiye

 

Background/aim: The aim was to compare the pre- and posttransport levels of systemic inflammatory markers in neonatal infants transported to a tertiary intensive care unit via emergency health services with a neonatal respiratory distress syndrome (nRDS) diagnosis and to assess the quality of transport. Materials and methods: This retrospective study was conducted between January 2019 and December 2023. A total of 117 nRDS patients' emergency transports were included in the study. Demographic data, transfer time, intubation, cold treatment, cardiopulmonary resuscitation (CPR), and pre- and posttransport laboratory parameters were obtained retrospectively. The statistical analysis was performed using IBM SPSS Statistics (Version 22.0), with a significance level of p < 0.05. Results: The mean gestational age at birth was 35.46 +/- 4.189 weeks. Among the neonates transported, 41.9% (n = 49) were intubated and 41.9% (n = 49) required mechanical ventilation during transport. CPR was performed in 12.8% (n = 15) of cases, with 4.3% (n = 5) requiring prolonged CPR. The mortality rate was 11.1% (n = 13). The mean neutrophil-to-lymphocyte ratio (NLR) was 3.0 +/- 3.40, the platelet-to-lymphocyte ratio (PLR) was 101.2 +/- 103.9, the systemic inflammatory index (SII) (x103) was 1.91 +/- 2.43, and the haemoglobin, albumin, lymphocyte, platelet (HALP) score was 10.42 +/- 21.36. No statistically significant differences were observed between the pre- and posttransfer values of the NLR, PLR, HALP index, or SII (overall p > 0.05). Conclusion: No significant differences were detected between pre- and posttransport inflammatory marker levels. These findings suggest that the transport process may not be associated with a measurable inflammatory response, possibly reflecting the effectiveness of appropriate treatment and stabilisation during transport.