Hemodynamic effects of altitude exposure and oxygen administration in chronic obstructive pulmonary disease

Berg, Benjamin W.; Dillard, Thomas A.; Derderian, Sarkis S.; Rajagopal, Krishnan R.

doi:10.1016/0002-9343(93)90152-f

Cited by 28 publications

(20 citation statements)

References 26 publications

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“…It has been shown that supplemental oxygen may reverse the hyperventilatory response to hypobaric hypoxia in patients with COPD, thereby having a positive influence on the feeling of dyspnoea [28]. Supplemental oxygen may also cause beneficial haemodynamic changes [29]. It should be noted, however, that the effect of supplemental oxygen in the current study was not placebo controlled, and it has previously been shown that oxygen treatment is encumbered with a considerable placebo effect [30].…”

Section: Discussionmentioning

confidence: 58%

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

Edvardsen

Ryg²,

Akerø

et al. 2012

Eur Respir J

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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.

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Section: Discussionmentioning

confidence: 58%

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

Edvardsen

Ryg²,

Akerø

et al. 2012

Eur Respir J

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“…Such laboratory-based studies, however, are often limited in duration ( , 1 h) and exclude additional stressors encountered during air travel, such as exertion, dehydration, and sleep deprivation. [8][9][10][11][12][13] Our study contributes new data about an understudied condition that affects a distinctly different patient population composed predominantly of relatively younger women. Moreover, we adopted an underused, "real-world" approach by studying patients during actual fl ight.…”

Section: Discussionmentioning

confidence: 99%

“…Enrolled subjects were each given a fl ight log and instructed to perform 10 sets of recordings for Sp o 2 , HR, and cabin pressure (measured as equivalent altitude ASL) at different stages during the fl ight: (1) preboarding, (2) seated before take-off, (3) during ascent, (4) at cruising altitude, (5) 15 min after reaching cruising altitude, (6) after walking to the lavatory (performed per protocol), (7) at initial descent, (8) prior to fi nal descent, (9) immediately after landing, and (10) at fi nal destination. Participants were also allowed to perform up to two additional discretionary sets of readings at cruising altitude.…”

mentioning

confidence: 99%

Effects of Commercial Air Travel on Patients With Pulmonary Hypertension

Roubinian

Elliott

Barnett

et al. 2012

Chest

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Each year, as many as 800 million people travel by commercial aircraft worldwide. 1 To ensure passenger safety on US carriers, the Federal Aviation Administration requires that cabin pressure during fl ight be maintained at pressures equivalent to an altitude of Յ 2,438 m (8,000 ft) above sea level (ASL). Passengers with chronic lung disease, however, may experience signifi cant hypoxemia and physiologic stress resulting from changes in cabin pressure even within these mandated limits. 2 Among those with lung disease, people with pulmonary hypertension (PH) are at particularly high risk of adverse effects due to hypoxic pulmonary vasoconstriction. 3 Indeed, even modest levels of hypoxemia experienced during fl ight could result in further elevation of pulmonary artery pressures, thus leading to increased myocardial oxygen demand and hemodynamic compromise.Background: Limited data are available on the effects of air travel in patients with pulmonary hypertension (PH), despite their risk of physiologic compromise. We sought to quantify the incidence and severity of hypoxemia experienced by people with PH during commercial air travel. Methods: We recruited 34 participants for a prospective observational study during which cabin pressure, oxygen saturation (Sp O 2 ), heart rate, and symptoms were documented serially at multiple predefi ned time points throughout commercial fl ights. Oxygen desaturation was defi ned as Sp O 2 , 85%. Abbreviations: ASL 5 above sea level; HR 5 heart rate; PH 5 pulmonary hypertension; Sp o 2 5 oxygen saturation; WHO 5 World Health Organization

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“…The large number of UK centres that took part and of patients recruited suggests, as previously noted, that potential problems associated with respiratory disease and air travel are well recognised [8], as is the need for more substantial evidence on which to base future recommendations. With a few exceptions [9][10][11][12], previous studies aimed at determining risk in adult passengers have examined small numbers of patients with COPD [13][14][15][16][17][18][19][20][21][22] in the acute setting. They have largely excluded comorbidity and studied stable patients.…”

Section: Discussionmentioning

confidence: 99%

Is air travel safe for those with lung disease?

Coker¹,

Shiner²,

Partridge³

2007

Eur Respir J

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Airlines commonly report respiratory in-flight emergencies; flight outcomes have not been examined prospectively in large numbers of respiratory patients. The current authors conducted a prospective, observational study of flight outcomes in this group.UK respiratory specialists were invited to recruit patients planning air travel. Centres undertook their usual pre-flight assessment. Within 2 weeks of returning, patients completed a questionnaire documenting symptoms, in-flight oxygen use and unscheduled healthcare use.In total, 616 patients were recruited. Of these, 500 (81%) returned questionnaires. The most common diagnoses were airway (54%) and diffuse parenchymal lung disease (23%). In total, 12 patients died, seven before flying and five within 1 month. Pre-flight assessment included oximetry (96%), spirometry (95%), hypoxic challenge (45%) and walk test (10%). Of the patients, 11% did not fly. In those who flew, unscheduled respiratory healthcare use increased from 9% in the 4 weeks prior to travel to 19% in the 4 weeks after travel. However, when compared with selfreported data during the preceding year, medical consultations increased by just 2%.In patients flying after careful respiratory specialist assessment, commercial air travel appears generally safe.

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Hemodynamic effects of altitude exposure and oxygen administration in chronic obstructive pulmonary disease

Cited by 28 publications

References 26 publications

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

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

Effects of Commercial Air Travel on Patients With Pulmonary Hypertension

Is air travel safe for those with lung disease?

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