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Modern aircraft flying at high altitude are cabin pressurised to an atmospheric partial pressure of up to 8000 feet (2348 metres), equivalent to breathing approximately 15% oxygen. This may expose individuals with cardiorespiratory disease to the risk of developing hypoxia. In 2002 the British Thoracic Society (BTS) issued recommendations for passengers with respiratory diseases who are planning to fly.1 These recommendations included the use of a hypoxic challenge test in children with a history of respiratory disease too young to undergo conventional lung function tests. While pre-flight hypoxic challenge tests have been evaluated in older children2 and adults3 with respiratory disease, there are few data on hypoxic responses in infants and young children with respiratory disease although one study has observed profound desaturation in a small number of healthy infants while asleep.4
In the last 6 years we have tested …