Flying with Respiratory Disease

Tzani, Panagiota; Pisi, Giovanna; Aiello, Marina; Olivieri, Dario; Chetta, Alfredo

doi:10.1159/000313425

Cited by 24 publications

(26 citation statements)

References 91 publications

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“…Consecutively, this decrease in ambient oxygen partial pressure translates into a considerable decrease in the oxygen saturation in the peripheral blood (85 and 91%, respectively) and mean arterial oxygen pressure (53 and 64 mm Hg, respectively), nota bene in healthy volunteers [48] . In healthy subjects, this decrease in oxygen saturation is well tolerated in most instances, whereas hypoxia during aircraft travel may induce discomfort and medical complications in patients with pulmonary diseases [49] . While our study on increased activity in IBD patients after exposure to hypoxia [45] indeed revealed a significant association between inflammation and hypoxia, there are currently no clinical studies available in the literature.…”

Section: Key Messagesmentioning

confidence: 99%

High Altitude Journeys, Flights and Hypoxia: Any Role for Disease Flares in IBD Patients?

Vavricka

Rogler

Biedermann

2016

Dig Dis

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The importance of environmental factors in the pathogenesis including their disease-modifying potential are increasingly recognized in inflammatory bowel disease (IBD) patients, largely driven by the perception that the prevalence and incidence of IBD are on the rise within the last few years, especially in non-western countries. One of those factors is believed to be hypoxia. The role of hypoxia as a modifying or even causative factor in the genesis and maintenance of inflammation has been increasingly elucidated in recent years. Hypoxia is believed to be a main inducing factor of inflammation. This has been studied in different animal experiments as well as in humans exposed to hypoxia. In several studies -mainly in mice -animals exposed to short-term hypoxia accumulated inflammatory cells in multiple organs and showed elevated cytokines in the blood. Comparable studies were performed in humans, mainly in healthy mountaineers. Recently, we reported on the association between IBD flare-up episodes and antecedent journeys to high-altitude region and aircraft travels. According to these findings, we concluded that flights and stays at high altitudes of >2,000 mg are a risk factor for increased disease activity in IBD. To evaluate the potential influence of hypoxia on the course of IBD on a biomolecular level and to test the effects of hypoxia under standardized conditions, we initiated a prospective and controlled investigation in both healthy controls and IBD patients in stable remission. The study participants underwent a 3-hour exposure to hypoxic conditions simulating an altitude of 4,000 m above sea level in a hyperbaric pressure chamber and clinical parameters as well as blood and stool samples were collected at several time points. The first results of this study are expected in the near future. studies -mainly in mice -animals exposed to short-term hypoxia accumulated inflammatory cells in multiple organs and showed elevated cytokines in the blood. Comparable studies were performed in humans, mainly in healthy mountaineers. Recently, we reported on the association between IBD flare-up episodes and antecedent journeys to high-altitude region and aircraft travels. According to these findings, we concluded that flights and stays at high altitudes of >2,000 mg are a risk factor for increased disease activity in IBD. To evaluate the potential influence of hypoxia on the course of IBD on a biomolecular level and to test the effects of hypoxia under standardized conditions, we initiated a prospective and controlled investigation in both healthy controls and IBD patients in stable remission. The study participants underwent a 3-hour exposure to hypoxic conditions simulating an altitude of 4,000 m above sea level in a hyperbaric pressure chamber and clinical parameters as well as blood and stool samples were collected at several time points. The first results of this study are expected in the near future. AbstractThe importance of environmental factors in the pathogenesis including their disease-modifyi...

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Section: Key Messagesmentioning

confidence: 99%

High Altitude Journeys, Flights and Hypoxia: Any Role for Disease Flares in IBD Patients?

Vavricka

Rogler

Biedermann

2016

Dig Dis

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“…Because of this, the partial pressure of oxygen in inspired gas (PiO 2 ) decreases by 40 mm Hg as compared to sea level. These pressure changes are attained approximately 15 min following takeoff [6]. …”

Section: Discussionmentioning

confidence: 99%

“…The average increase in gas volume upon moving from the ground to 8,000 ft osl is approximately 30%. The reduction in atmospheric pressure that occurs during ascent can cause a dramatic increase in noncommunicating gas volume and consequently rupture of an underlying pulmonary cystic lesion leading to pneumothorax, and this is the likely mechanism in the index case also [6]. …”

Section: Discussionmentioning

confidence: 99%

“…Also, presence of an underlying pneumothorax is an absolute contraindication for air travel as a critical increase in pressure and volume may occur. The other two absolute contraindications for air travel are bronchogenic cysts and severe pulmonary arterial hypertension [6]. Cases of patients with bronchogenic cysts developing in-flight complications like systemic gas embolism (mostly fatal) have been previously reported [6].…”

Section: Discussionmentioning

confidence: 99%

“…The other two absolute contraindications for air travel are bronchogenic cysts and severe pulmonary arterial hypertension [6]. Cases of patients with bronchogenic cysts developing in-flight complications like systemic gas embolism (mostly fatal) have been previously reported [6]. In patients with suggestive symptoms, spontaneous pneumothorax or pneumomediastinum must be excluded prior to air travel.…”

Section: Discussionmentioning

confidence: 99%

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In-Flight Spontaneous Pneumothorax: Congenital Cystic Adenomatoid Malformation of the Lung

Madan

Gella

Singh³

2012

Respiration

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Congenital cystic adenomatoid malformation (CCAM) is a rare congenital abnormality. Symptomatic presentation in adult life is extremely uncommon. The usual radiological appearance of CCAM is a cystic space-occupying lesion. Patients with underlying cystic lung disease can develop in-flight complications because of pressure-volume changes during ascent. We report the first ever case in which spontaneous pneumothorax during flight was the presenting manifestation of CCAM of the lung in a previously healthy and asymptomatic young adult. We also discuss the physiological changes during air travel which contribute to the pathogenesis of respiratory complications during air travel.

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Travelers with underlying medical conditions

McCarthy

Suh

2015

Essential Travel Medicine

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Flying with Respiratory Disease

Cited by 24 publications

References 91 publications

High Altitude Journeys, Flights and Hypoxia: Any Role for Disease Flares in IBD Patients?

High Altitude Journeys, Flights and Hypoxia: Any Role for Disease Flares in IBD Patients?

In-Flight Spontaneous Pneumothorax: Congenital Cystic Adenomatoid Malformation of the Lung

Travelers with underlying medical conditions

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