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The Physiological Impact of Neonatal Air Transport: A Review of The Literature
Ian Braithwaite1, Cath Harrison1
1Embrace, Yorkshire and Humber Infant and Children's Transport Service, Sheffield Children's NHS Foundation Trust, Barnsley, South Yorkshire, United Kingdom.
Insights
Neonatal air transport is as safe as ground transport for infants. Studies show no significant physiological differences, even for high-risk newborns, making air travel a viable option.
Area of Science:
- Neonatal transport medicine
- Pediatric critical care
- Transport physiology
Background:
- Neonatal transport is critical for specialized care.
- Concerns exist regarding the physiological impact of air transport versus ground transport.
Purpose of the Study:
- To evaluate the physiological effects of neonatal air transport compared to ground transport.
- To determine if air transport poses greater risks to neonatal patients.
Main Methods:
- Systematic literature review of studies comparing neonatal air and ground transport.
- Inclusion criteria focused on patient outcomes and physiological responses during transport.
- Analysis of 13 eligible studies, including observational and retrospective designs.
Main Results:
- No significant difference in patient stability or outcomes between air and ground transport.
- Air transport (fixed-wing or helicopter) was not found to be more physiologically challenging.
- Studies examined physiological stability scores, intraventricular hemorrhage rates, clinical interventions, and physical forces.
Conclusions:
- Current evidence suggests equivalent safety profiles for neonatal air and ground transport.
- Air transport is a viable option for all neonatal patients, including high-risk groups.
- Patient stability and outcomes are comparable regardless of transport mode.
Objective:
This review aims to enhance our understanding around whether neonatal air transport has an adverse physiological impact on patients.
Methods:
A literature search included articles describing both ground and air transport. Eligible studies had to include patient outcome and/or response to the journey in such a way that the physiological impact of neonatal transport could be compared between the 2 groups.
Results:
The search produced 13 eligible studies. Six were prospective observational cohort studies, and the remainder were retrospective. When assessing outcome, studies used a physiological stability score, the rate and severity of intraventricular hemorrhage, the type and frequency of clinical interventions during the journey, or a specific clinical parameter. Three of the studies sought to understand the physiological impact of transport by investigating the variation in the physical forces experienced.
Conclusion:
The current published evidence does not suggest one mode of transport is preferable to another when considering patient stability and outcome. Neonatal fixed wing or helicopter transport has not been shown to be more physiologically challenging for the patient than road transport, even by teams who are regularly flying patients in the highest-risk groups (extremely preterm, in the first hours of life).
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