title: Blood gas-analyses in patients with cystic fibrosis to estimate hypoxemia during exposure to high altitudes in a hypobaric-chamber.
abstract: OBJECTIVE
  Patients with cystic fibrosis (CF) represent a special risk for commercial airlines. Even on ground conditions the oxygen partial pressure (paO subset2) of these patients is partially clearly reduced. The reduced air pressure on board of an airplane can cause a drop of the paO subset2 to a critical point (below 50 mmHg) during a flight. Therefore, medical assistance or at least oxygen-supply over a longer time period could be necessary. Aim of this study was to investigate reaction and clinical outcome of patients with CF during a hypobaric-chamber-flight at altitudes of 2. 000 and 3.000 m to appraise their risk for a flight-trip.
  
  
  METHODS
  10 CF-patients (age 19-35 years, mean age 30 y) were investigated in a hypobaric chamber prior to an already booked flight-trip to the Baleares (Spain). Lung-function, oxygen saturation (SO subset2) and paO subset2 by pressure adjusted blood gas analysis were measured on ground level, at 2.000 m and 3.000 m pressure-altitude.
  
  
  RESULTS
  Forced expiratory vital capacity (FVC) over the entire group was 2. 9 l (range 1.4 to 4.0 l), forced expiratory 1-second volume (FEV subset1) 2.08 l/sec (range: 1.22 to 3.61 l/sec). Values dropped slightly at 3.000 m chamber altitude (VC=2.7 l, FEV subset1=1.95 l/sec). SO subset2 decreased from 95 % on ground to 89% at 2.000 m and 86 % at 3.000 m chamber altitude. paO2 decreased from 79.5 mmHg at ground level to 60 mmHg at 2000m and 45.5 mmHg at 3.000 m. Only one patient with a paO subset2 of 52 mmHg didn t fall below the critical flight limit of 50 mmHg. No patient felt below a paO subset2 of 40 mmHg. No patient experienced dyspnea during the chamber flight. Two patients without subjective symptoms before the chamber flight developed mild ear blocks during descent presumably due to swollen polyps. Complaints improved quickly by applying decongestant nose-spray. -
  
  
  CONCLUSIONS
  The results of the chamber flights indicate that chronically adapted adult lung disease patients without accompanying heart disease and a paO subset2 of > 40 mmHg during flight can anticipate a safe flight trip. These results could be confirmed by the consecutive flight trip to Spain.
authors.affiliation: Institute of Occupational-, Social- and Environmental Medicine, Johannes Gutenberg-University of Mainz, Obere Zahlbacher Str. 67, D-55131 Mainz, Germany. rose@mail.uni-mainz.de
authors.forename: D M
authors.initials: DM
authors.lastname: Rose
authors.forename: B
authors.initials: B
authors.lastname: Fleck
authors.forename: O
authors.initials: O
authors.lastname: Thews
authors.forename: W E
authors.initials: WE
authors.lastname: Kamin
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000531:Altitude; D003550:Cystic Fibrosis / Q000097:blood*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D008297:Male; D010100:Oxygen / Q000097:blood*
chemical_list: D010100:Oxygen