{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:01:23Z","timestamp":1793437283209,"version":"4.5.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Interfacility transfer (IFT) of neonates and infants is common in South Africa, with many needing respiratory support. Recently, interest in non-invasive ventilation, particularly nasal continuous positive airway pressure (nCPAP), during IFTs has increased; however, local evidence is limited. This study aimed to describe the characteristics of neonates and infants requiring respiratory support and to evaluate the introduction of nCPAP during IFTs by the South African Red Cross Air Mercy Service (AMS) in the Western Cape between 2017 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective descriptive review of all neonates (\u2264 28\u2009days) and infants (\u2009&gt;\u200928\u2009days to \u2264 1\u2009year) requiring respiratory support during AMS IFTs was conducted between 2017 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Respiratory support was required for 70.4% (435\/618) of all neonates and infants transported during the study period. Of the 435 IFTs, 61.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009267) were neonates and 51.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009224) males. Approximately two-thirds (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009296, 68.0%) were transported by rotor-wing (RW) aircraft, and Emergency Care Practitioners (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009344, 79.1%) were the most common primary crew member. The median stabilisation time for RW and fixed-wing (FW) aircraft IFTs was\u2009&gt;\u200960\u2009mins, with median RW mission times approximately 3 hrs and\u2009&gt;\u20095.5 hrs for FW. Common diagnoses included respiratory distress syndrome in neonates and pneumonia in infants. During IFTs, 174 (40.0%) patients received oxygen (O\n                      <jats:sub>2<\/jats:sub>\n                      ) therapy, 141 (32.4%) nCPAP, and 120 (27.6%) positive pressure ventilation, predominantly mechanical ventilation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009116, 26.6%). Neonates more commonly received nCPAP during IFTs and infants\u2019 oxygen therapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, in neonates, the use of nCPAP increased over the three years, while O\n                      <jats:sub>2<\/jats:sub>\n                      therapy declined (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the frequency of neonatal and infant aeromedical IFTs requiring respiratory support and the increasing adoption of nCPAP during aeromedical IFTs in one South African province. The findings suggest that nCPAP is a feasible respiratory support modality in the aeromedical IFT context; however, the safe and effective implementation relies on careful patient selection, adequately trained personnel, and appropriate equipment. Further research is warranted to evaluate the overall safety and clinical outcomes of nCPAP during IFTs and develop robust protocols and guidelines tailored to the South African context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12873-025-01403-9","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T10:19:53Z","timestamp":1766571593000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Respiratory support during neonatal and infant aeromedical interfacility transfers in the Western Cape, South Africa: a retrospective review"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0180-6017","authenticated-orcid":false,"given":"Andrit","family":"Lourens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-805X","authenticated-orcid":false,"given":"Johanna Catharina","family":"Botha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7274-9049","authenticated-orcid":false,"given":"Garth","family":"Moys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cally","family":"Stephen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Werthmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8444-9141","authenticated-orcid":false,"given":"Jocelyn","family":"Park-Ross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6057-5001","authenticated-orcid":false,"given":"Sandi","family":"Holgate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"1403_CR1","unstructured":"United Nations Inter-agency Group for Child Mortality Estimation. 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Permission to conduct research and access AMS data sources was received from the Red Cross AMS and the WC Government Department of Health (WC_202106_006). The study adhered to ethical standards set out by the Declaration of Helsinki. Given the retrospective nature of the study and the use of anonymised patient data extracted from existing medical records, the requirement for informed consent was waived. The study involved no direct contact with patients; therefore, care was not influenced, nor did patients incur any risks or direct benefits. Only data relevant to the research question were captured. No personally identifiable information of the treating practitioners was extracted, and the data were captured under the unique service number of each IFT. All data related to the study were securely stored on the primary authors\u2019 password-protected laptop.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Some of the authors were employed by the Red Cross Air Medical Service (AMS) during the conduct of the study. However, the organisation did not influence data interpretation or the decision to submit the manuscript for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"258"}}