Hypercapnic Respiratory Acidosis During An In-Flight Oxygen Assessment

Straying away from a sedentary lifestyle is essential, especially in these troubled times of a global pandemic to reverse the ill effects associated with the health risks as mentioned earlier. In the view of anticipated effects on immune system and prevention against influenza and Covid-19, globally moderate to vigorous exercises are advocated wearing protective equipment such as facemasks. Though WHO supports facemasks only for Covid-19 patients, healthy "social exercisers" too exercise strenuously with customized facemasks or N95 which hypothesized to pose more significant health risks and tax various physiological systems especially pulmonary, circulatory and immune systems. Exercising with facemasks may reduce available Oxygen and increase air trapping preventing substantial carbon dioxide exchange. The hypercapnic hypoxia may potentially increase acidic environment, cardiac overload, anaerobic metabolism and renal overload, which may substantially aggravate the underlying pathology of established chronic diseases. Further contrary to the earlier thought, no evidence exists to claim the facemasks during exercise offer additional protection from the droplet transfer of the virus. Hence, we recommend social distancing is better than facemasks during exercise and optimal utilization rather than exploitation of facemasks during exercise.

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“…Further, poor saturation of haemoglobin would be anticipated due to increased partial pressure of CO 2 at higher exercise intensity [19]. Fig.…”

Section: Metabolism Altercationmentioning

confidence: 99%

“Exercise with facemask; Are we handling a devil's sword?” – A physiological hypothesis

2020

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“…In-flight oxygen may be contraindicated in adults and children with a history of type 2 respiratory failure 17 18. Hypoxic challenge with arterial carbon dioxide tension (PaCO 2 ) measurement was advised for this group in 199617 but there has been little research since.…”

Section: Methodsmentioning

confidence: 99%

“…Previous BTS advice was to err on the side of recommending oxygen if in doubt,1 and other authors have recommended doubling oxygen flow rates for patients with a pre-existing oxygen requirement 1 29. However, there is a potential risk of developing hypercapnia and respiratory acidosis from oxygen during HCT in patients with type 2 respiratory failure 18. Patients with a history of hypercapnia should ideally undergo HCT with blood gas sampling.…”

Section: Methodsmentioning

confidence: 99%

“…1 29 However, there is a potential risk of developing hypercapnia and respiratory acidosis from oxygen during HCT in patients with type 2 respiratory failure. 18 Patients with a history of hypercapnia should ideally undergo HCT with blood gas sampling. In these cases, the minimum amount of oxygen should be delivered to maintain PaO 2 ≥6.6 kPa while monitoring PaCO 2 and pH.…”

Section: Patients With Hypercapniamentioning

confidence: 99%

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BTS Clinical Statement on air travel for passengers with respiratory disease

Armstrong

Church

Holmes

et al. 2022

Thorax

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“…Die Sauerstoffgabe würde deshalb den Atemreiz vermindern. Bei solchen Patienten wird deshalb eine Kapnometrie empfohlen (42).…”

unclassified

Flugreisen bei Kindern

Siedenburg¹

2018

Kinder- und Jugendmedizin

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ZusammenfassungDas physiologische Milieu in Passagierflugzeugen ist durch einen beim Start abnehmenden und bei der Landung wieder zunehmenden Luftdruck, milde Hypoxie, Lufttrockenheit gekennzeichnet. Hinzu kommt die Zeitverschiebung. Für Notfälle steht eine umfangreiche Notfallausrüstung zur Verfügung. Gesunde Kinder und auch die meisten Kinder mit Vorerkrankungen tolerieren die Veränderungen an Bord in der Regel problemlos, bei Bedarf ist eine umfangreiche medizinische Zusatzausrüstung verfügbar. Auch schwerer erkrankte Kinder können auf dem Luftweg transportiert werden. Bei der Beurteilung der Flugreisetauglichkeit sind die besonderen physiologischen Umstände ebenfalls zu beachten. Die Empfehlungen haben in der Regel eine empirische Basis. Randomisierte, kontrollierte Studien, Metaanalysen oder Register sind kaum verfügbar. Bei seltenen, komplexen oder kritischen Krankheitsbildern muss die Flugreisetauglichkeit jedoch im Einzelfall unter Beteiligung der behandelnden Ärzte, ggf. weiteren Fachärzten und des verantwortlichen Flugmediziners individuell eingeschätzt werden.

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Hypercapnic Respiratory Acidosis During An In-Flight Oxygen Assessment

Cited by 9 publications

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“Exercise with facemask; Are we handling a devil's sword?” – A physiological hypothesis

“Exercise with facemask; Are we handling a devil's sword?” – A physiological hypothesis

BTS Clinical Statement on air travel for passengers with respiratory disease

Flugreisen bei Kindern

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