Neonatal Transport Using the TXP-2D High-Frequency Ventilator: A Tertiary Care Center Experience

Neonatal interfacility transport of critically ill infants with severe respiratory failure is challenging. Although high-frequency ventilation is maintstay in the neonatal intensive care unit, its use during transport has been historically limited by equipment size and complexity. The TXP-2D ventilator delivers high-frequency percussive ventilation, a hybrid modality potentially offering greater stability during transport. This study aimed to evaluate the safety, feasibility, and operational stability of the TXP-2D ventilator during neonatal transport.

We conducted a retrospective descriptive study of infants transported by a specialized neonatal transport team between January 2023 and December 2025. Demographic data, clinical diagnoses, physiological parameters, and ventilator settings were analyzed before, during, and after transport. The primary outcomes were stability during transport and the frequency of required ventilator adjustments.

Thirteen infants were transported on TXP-2D. Most (69%) required high-frequency oscillatory ventilation or high-frequency jet ventilation upon admission. Physiological parameters, including heart rate, mean blood pressure, and oxygen saturation, remained stable throughout transport. Most transports required zero ventilator adjustments after initiation; only 4 infants required a single setting change. No device malfunctions or unplanned extubations occurred. One patient experienced admission hypocarbia, but no transport-related mortalities were observed.

The use of the TXP-2D for HFV during neonatal ground transport is safe and feasible. The modality provides significant operational stability, requiring minimal intervention from the transport team. This "low-intervention" profile, supported by a standardized protocol, may reduce cognitive load and enhance safety during high-acuity transfers.