PMID- 23127571
OWN - NLM
STAT- MEDLINE
DCOM- 20130624
LR  - 20161125
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 107
IP  - 2
DP  - 2013 Feb
TI  - Hypoxaemia in patients with pulmonary arterial hypertension during simulated air 
      travel.
PG  - 298-304
LID - S0954-6111(12)00390-3 [pii]
LID - 10.1016/j.rmed.2012.10.007 [doi]
AB  - BACKGROUND: Recent air travel recommendations suggest patients with precapillary 
      pulmonary hypertension (PCPH) in New York Heart Association (NYHA) functional 
      class 3 and 4 should have in-flight oxygen without the need for pre-flight 
      testing. However it remains unclear as to how best to determine patients fitness 
      to fly. METHODS: This study (i) investigates the effect of hypoxic challenge 
      testing (HCT) on the arterial oxygen levels in a cohort of 36 patients with PCPH 
      and (ii) compares the relative frequency with which FC and HCT predict the 
      requirement for in-flight oxygen. RESULTS: The degree of arterial hypoxaemia 
      induced by HCT (fall in partial pressure of oxygen in arterial blood (PaO(2)) 
      2.36 kPa, 95% CI 2.06-2.66 kPa) was similar to the drop observed in other 
      published studies of chronic respiratory diseases. Following current air travel 
      recommendations based on FC, 25 patients of the cohort would require in-flight 
      oxygen whilst 10 subjects failed the HCT. Fourteen subjects had flown 
      post-diagnosis. Of these, nine subjects should have had in-flight oxygen based on 
      FC but were asymptomatic without. Also one who passed the HCT had developed 
      symptoms during the flight whilst three who failed the HCT were asymptomatic 
      flying without in-flight oxygen. CONCLUSIONS: Hypoxaemia induced by simulated air 
      travel in patients with PCPH is similar to that seen in published studies of 
      patients with other chronic respiratory diseases. HCT failed to predict correctly 
      who had developed symptoms during an aircraft flight in a significant minority of 
      the study subjects. Similarly guidelines based on functional class result in a 
      major increase in the proportion of patients being advised to use oxygen, many of 
      whom had been asymptomatic on previous flights without it. More work is required 
      to improve prediction of need for in-flight oxygen in patients with PCPH.
CI  - Copyright (c) 2012. Published by Elsevier Ltd.
FAU - Burns, R M
AU  - Burns RM
AD  - Scottish Pulmonary Vascular Unit, Golden Jubilee Hospital, Agamemnon Street, 
      Clydebank, Glasgow G81 4DY, UK.
FAU - Peacock, A J
AU  - Peacock AJ
FAU - Johnson, M K
AU  - Johnson MK
FAU - Church, A C
AU  - Church AC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121103
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Aerospace Medicine/*methods
MH  - Aged
MH  - Aircraft
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/blood/*complications/therapy
MH  - Hypoxia/blood/*etiology
MH  - Male
MH  - Middle Aged
MH  - Oxygen/blood
MH  - Oxygen Inhalation Therapy
MH  - Partial Pressure
MH  - Physical Fitness
MH  - Practice Guidelines as Topic
MH  - *Travel
EDAT- 2012/11/07 06:00
MHDA- 2013/06/26 06:00
CRDT- 2012/11/07 06:00
PHST- 2012/03/07 00:00 [received]
PHST- 2012/10/02 00:00 [revised]
PHST- 2012/10/15 00:00 [accepted]
PHST- 2012/11/07 06:00 [entrez]
PHST- 2012/11/07 06:00 [pubmed]
PHST- 2013/06/26 06:00 [medline]
AID - S0954-6111(12)00390-3 [pii]
AID - 10.1016/j.rmed.2012.10.007 [doi]
PST - ppublish
SO  - Respir Med. 2013 Feb;107(2):298-304. doi: 10.1016/j.rmed.2012.10.007. Epub 2012 
      Nov 3.