II. Indications: Preflight Assessment of Respiratory Conditions
- Bullous Lung Disease
- Automated Ventilator Support (e.g. CPAP)
- Cystic Fibrosis
- Acute respiratory illness requiring hospitalization within last 6 weeks
- Preexisting Supplemental Oxygen or Ventilatory requirements
- History of respiratory distress on prior air travel
- Pulmonary Tuberculosis
- Recent Pneumothorax (esp. residual Pneumothorax)
- Severe COPD (Predicted FEV1 <30%)
- Severe Persistent Asthma
- Severe Restrictive Lung Disease (Vital Capacity <1 L)
III. Evaluation: Hypoxia Altitude Simulation Test
- Technique
- Patient breaths air wih 15% FIO2 via mask (room air at sea level is FIO2 of 23%) for 20 minutes
- Pulse Oximetry and Blood Gas are performed before and after breathing 15% oxygen
- Interpretation
- PaO2 <50 mmHg at any point indicated Supplemental Oxygen requirements
- PaO2 >55 mmHg does NOT require Supplemental Oxygen
- References
IV. Management: Air Travel Restrictions
-
Hypoxia
- Avoid air travel
- Chronic, stable Supplemental Oxygen requirements <4 L/min
- Double usual oxygen flow rate during flight
- Portable oxygen compressors are allowed on flight per FAA, but require >48 hour notice to airline
-
Chronic Obstructive Pulmonary Disease (COPD)
- No air travel if Vital Capacity <50% of predicted
-
Asthma
- No restriction if stable
-
Pneumothorax
- No flight for 10 days after resolution
- Open-ChestLung Procedure
- Avoid air travel for 2-3 weeks
- Assess for Supplemental Oxygen before travel
- No recent or residual Pneumothorax at time of air travel