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Background <p>Rapid transportation of neurosurgical patients, particularly those with acute spinal trauma, is critical due to the direct association between total prehospital time and mortality. While existing aeromedical guidelines focus primarily on helicopter (rotor-wing) transport, there is limited evidence consolidating the effects of fixed-wing aircraft transport, which exposes patients to unique physiological stressors due to higher operational altitudes.</p> Methods <p>Using a recognised framework for scoping reviews, a European-based research team conducted biweekly discussions to ensure a comprehensive approach.&#xa0;This scoping review utilized a four-phase framework: identification, screening, data extraction, and contextualisation. A systematic literature search via OVID databases up to September 19, 2024, and manual searches of 15 journals identified studies involving fixed-wing aircraft transport for spinal pathology patients, excluding helicopter or animal studies.&#xa0;Additionally, a panel of experts in neurosurgery and aviation reflected on their experiences and transferable lessons.</p> Results <p>12 studies were included, covering 105 spinal injury cases and 1 spinal tuberculosis case. Key physiological factors unique to fixed-wing transport include reduced atmospheric pressure, low humidity, extended transport duration, smoother acceleration/deceleration, and better medical accessibility compared to rotor-wing transport. Recommendations from the literature and expert experiences emphasise respiratory stability, humidification, oxygen supplementation, pressure injury prevention, bowel/bladder management, airway cuff pressure management, and venous thromboembolism prophylaxis.</p> Conclusion <p>There is an urgent need for evidence-based recommendations tailored to fixed-wing transportation of spinal pathology patients, emphasizing altitude-induced physiological changes to optimize patient safety. Further targeted research is essential to develop comprehensive clinical protocols.</p>

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Fixed-wing air transport of patients with spinal pathologies: a scoping review of current evidence and future research priorities

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月2日

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  • Ashviniy Thamilmaran,
  • Zak Hodgson,
  • Konstantinos Peramatzis,
  • Maria Karampouga,
  • Mark Jarratt,
  • Eleni Tsianaka,
  • Insa K. Janssen,
  • Anastasia Tasiou,
  • Nese Keser,
  • Mary Murphy

摘要

Background

Rapid transportation of neurosurgical patients, particularly those with acute spinal trauma, is critical due to the direct association between total prehospital time and mortality. While existing aeromedical guidelines focus primarily on helicopter (rotor-wing) transport, there is limited evidence consolidating the effects of fixed-wing aircraft transport, which exposes patients to unique physiological stressors due to higher operational altitudes.

Methods

Using a recognised framework for scoping reviews, a European-based research team conducted biweekly discussions to ensure a comprehensive approach. This scoping review utilized a four-phase framework: identification, screening, data extraction, and contextualisation. A systematic literature search via OVID databases up to September 19, 2024, and manual searches of 15 journals identified studies involving fixed-wing aircraft transport for spinal pathology patients, excluding helicopter or animal studies. Additionally, a panel of experts in neurosurgery and aviation reflected on their experiences and transferable lessons.

Results

12 studies were included, covering 105 spinal injury cases and 1 spinal tuberculosis case. Key physiological factors unique to fixed-wing transport include reduced atmospheric pressure, low humidity, extended transport duration, smoother acceleration/deceleration, and better medical accessibility compared to rotor-wing transport. Recommendations from the literature and expert experiences emphasise respiratory stability, humidification, oxygen supplementation, pressure injury prevention, bowel/bladder management, airway cuff pressure management, and venous thromboembolism prophylaxis.

Conclusion

There is an urgent need for evidence-based recommendations tailored to fixed-wing transportation of spinal pathology patients, emphasizing altitude-induced physiological changes to optimize patient safety. Further targeted research is essential to develop comprehensive clinical protocols.