Chest
Original ResearchCOPDCOPD and Air Travel: Oxygen Equipment and Preflight Titration of Supplemental Oxygen
Section snippets
Materials and Methods
A randomized crossover trial of oxygen titration during a HAST and in an HC was performed. The Regional Committee for Medical Research Ethics (Oslo, Norway) approved the study, and written informed consent was obtained from the participants. Primary outcome was the effect of oxygen titration on Pao2 when supplemental oxygen was given during the HAST and compared with the gold standard of the HC. Secondary outcome was a comparison of the effect on Pao2 of the various types of oxygen equipment in
Preflight Tests
Demographics, lung function, preflight arterial blood gases results, and pulse oximetry values are presented in Table 1.
Simulated Flight and Oxygen Titration (HAST vs HC)
Without supplemental oxygen, Pao2 was somewhat lower during the HAST than in the HC (Table 2). The Bland-Altman plot showed that there was no relationship between the difference in Pao2 during the HAST and in the HC and the average Pao2 recorded (Fig 2). The Pao2 values during the HAST and in the HC were highly correlated (r = 0.86, P < .001). Nine patients (56%) reported
Discussion
Preflight titration of supplemental oxygen dose with the three principles of oxygen equipment allowed for air travel; compressed gaseous oxygen with continuous flow, an oxygen-conserving device, and a POC were evaluated. The data suggest that titration of supplemental oxygen via an NC during a HAST results in accumulation of oxygen within the facemask, giving falsely high Pao2 values. When comparing various types of oxygen equipment in the HC, compressed gaseous oxygen with continuous flow or
Conclusions
In summary, the HAST may be used to identify patients needing supplemental oxygen during air travel. However, oxygen titration using an NC during a HAST causes accumulation of oxygen within the facemask and underestimates the oxygen dose required. Use of an oxygen-conserving device gives similar Pao28,000 ft as oxygen with continuous flow and should, therefore, be used to minimize the number of oxygen cylinders needed. Acceptable in-flight Pao2 values may also be obtained using a POC, but the
Acknowledgments
Author contributions: Dr Akerø: contributed to the conception and design of the study; collecting, analyzing, and interpreting the data; and drafting and revising the manuscript.
Ms Edvardsen: contributed to the design of the study, collecting and interpreting the data, and drafting and revising the manuscript.
Dr Christensen: contributed to the design of the study, collecting and interpreting the data, and drafting and revising the manuscript.
Dr Owe: contributed to the design of the study,
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Physiological predictors of Hypoxic Challenge Testing (HCT) outcomes in Interstitial Lung Disease (ILD)
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Air travel and chronic obstructive pulmonary disease: A new algorithm for pre-flight evaluation
2012, ThoraxCitation Excerpt :In these two groups of patients, the level of in-flight hypoxaemia was difficult to predict, underlining the need for pre-flight testing with HAST. Even though HAST is increasingly used in pre-flight assessment,32 33 it is not widely available.11 21 HAST has been shown to be a good predictor of in-flight PaO218 32 34 35 and the results obtained are reproducible.32
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Funding/Support: The study was funded by the Department of Pulmonary Medicine, Oslo University Hospital Ullevål, and by funds from the Norwegian Foundation for Health and Rehabilitation.
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