COPD and air travel: does hypoxia-altitude simulation testing predict in-flight respiratory symptoms?

Abstract

The reduced pressure in an aircraft cabin may cause significant hypoxaemia and respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD). The current study evaluated whether there is a relationship between hypoxaemia obtained during hypoxia-altitude simulation testing (HAST), simulating an altitude of 2438 m, and the reporting of respiratory symptoms during air travel.82 patients with moderate to very severe COPD answered an air travel questionnaire. Arterial oxygen tensions during HAST (PaO 2HAST ) in subjects with and without in-flight respiratory symptoms were compared. The same questionnaire was answered within 1 year after the HAST.Mean¡SD PaO 2HAST was 6.3¡0.6 kPa and 62 (76%) of the patients had PaO 2HAST ,6.6 kPa. 38 (46%) patients had experienced respiratory symptoms during air travel. There was no difference in PaO 2HAST in those with and those without in-flight respiratory symptoms (6.3¡0.7 kPa versus 6.3¡0.6 kPa, respectively; p50.926). 54 (66%) patients travelled by air after the HAST, and patients equipped with supplemental oxygen (n523, 43%) reported less respiratory symptoms when flying with than those without such treatment (four (17%) versus 11 (48%) patients; p50.039).In conclusion, no difference in PaO 2HAST was found between COPD patients with and without respiratory symptoms during air travel. @ERSpublications Hypoxia-altitude simulation testing does not predict in-flight respiratory symptoms in COPD patients http://ow.ly/nUCtF For editorial comments see page 1175.

Bench Evaluation of Four Portable Oxygen Concentrators Under Different Conditions Representing Altitudes of 2438, 4200, and 8000 m

“…We know that titrating supplemental oxygen during a hypoxia challenge test is uncertain due to accumulation of O2 under the face mask (Akerø et al, 2011). We also know that the HCT is good to predict in-flight PaO2, but not inflight symptoms (Edvardsen et al, 2013). Therefore, the recommendation to give 2 l/min of supplemental oxygen in-flight is in most cases could be the only practical choice.…”

Should I stay or should I go? COPD and air travel

“…KCO correlated both with resting altitude SaO 2 and exercise PaO 2 EDVARDSEN [57] 2012 100 severe COPD HCT and 6MWT An algorithm was constructed using a combination of resting and 6MWT SpO 2 . Resting SpO 2 >95% combined with 6MWT SpO2 >84% had a sensitivity of 100% and specificity of 80% for fitness to fly EDVARDSEN [58] 2013 82 moderate-to-severe COPD HCT and pre-and post-flight symptom questionnaire…”

Air Travel for Subjects Receiving Long-Term Oxygen Therapy

“…The increased incidence of symptoms during flying is consistent with previous studies. 19,20 Respiratory symptoms of dyspnea and air hunger during air travel were reported by 21% of subjects with COPD, compared with 4% of healthy subjects, but these were not subjects with oxygen supplementation.…”