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Perspectives from military neonatal transport: past, present, and future


This article traces the historical development of neonatal transport, from ancient Greek mythology to the modern era, with a particular focus on the contributions of U.S. military aviation. The narrative begins with early efforts in thermoregulation through stationary incubators and progresses to the pivotal role of aerial hospitals during World War II. Post-WWII, the establishment of neonatal transport services in New York and advancements in incubator technology set the stage for further innovation. The U.S. military’s involvement in neonatal transport, initiated in the 1970s, witnessed significant milestones, including the adaptation of ECMO technology for air transport. The narrative unfolds through the lens of U.S. military neonatology in the Western Pacific, particularly at Clark Air Base. The article concludes with insights into the U.S. Indo-Pacific Command’s neonatal transport mission, highlighting challenges faced during the SARS-CoV-2/COVID-19 pandemic and the development of specialized infection containment transport systems.

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Fig. 1: McDonnell Douglas C-9A Nightingale aeromedical evacuation aircraft.
Fig. 2: Historical events and capabilities in US military neonatal transport.
Fig. 3: Transport data map.

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We would like to acknowledge former U.S. Air Force and Army leaders in transport medicine for their correspondence, historical orations, and provision of photography: Drs. Reese Clark, Robert DiGeronimo, Dan Dirnberger, Dale Gerstmann, Howard Heiman, Jay Kerecman, Donald Null, and Bradley Yoder. Separately, we are indebted to the leaders, neonatologists, neonatal transport nurses, and respiratory therapists of Kadena Air Base’s 18th Medical Group/Critical Care Air Transport Team, U.S. Naval Hospital Okinawa, and Tripler Army Medical Center for their support of the neonatal transport mission in the Western Pacific. The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the United States Air Force, Department of Defense, or the United States Government. I am a military service member (or employee of the U.S. Government). This work was prepared as part of my official duties. Title 17, USC, §105 provides that ‘Copyright protection under this title is not available for any work of the U.S. Government.’ Title 17, USC, §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

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KMO and EVS created the article conception and design. KMO, CMD, and EVS each participated in data collection and manuscript preparation. All authors reviewed the work and approved the final version of the manuscript.

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Correspondence to Elizabeth V. Schulz.

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Schulz, E.V., Drumm, C.M. & Ottolini, K.M. Perspectives from military neonatal transport: past, present, and future. J Perinatol (2024).

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