Episodic hypoxemia in an airline passenger with chronic respiratory failure on supplemental oxygen.
Assessing the requirements for in-flight oxygen in passengers with pulmonary limitations can be a challenging task for clinicians. Aeromedical guidelines are available to help identify passengers that may require oxygen in flight. However, little is known about the actual in-flight response to passengers on oxygen. We measured the oxygen response (pulse oximetry) of a 67-yr-old female patient with chronic respiratory failure during a trans-Tasman flight (duration 170 min). This patient was assessed at the respiratory clinic before her journey and resting PaO2 (57 mmHg) indicated the requirement for in-flight oxygen. Bottled oxygen delivered at 2 L x min(-1) via nasal cannula was prescribed for her journey. Preflight SpO2 without supplemental oxygen was 92%. Mean in-flight SpO2 was well maintained at 93% while on oxygen at rest. There were four significant hypoxic events, which included light physical activity while on oxygen (three events; SpO2 to 84%) and a visit to the lavatory (off oxygen; SpO2 to 70%). Dyspnea and dizziness were reported during the lavatory visit. This case illustrates the importance of a preflight medical screening for passengers considered at risk during air travel and provides insight into the response of oxygen supplementation during flight.
Respiratory Physiology Laboratory, Christchurch Hospital, Christchurch, New Zealand. paul.kelly@cdhb.govt.nz
Paul T
PT
Kelly
Michael
M
Hlavac
Lutz E
LE
Beckert
D000337:Aerospace Medicine; D000368:Aged; D002908:Chronic Disease; D004244:Dizziness / Q000503:physiopathology; D004417:Dyspnea / Q000503:physiopathology; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000097:blood* / Q000503:physiopathology; D009043:Motor Activity / Q000502:physiology; D010092:Oximetry; D010102:Oxygen Inhalation Therapy; D012131:Respiratory Insufficiency / Q000097:blood / Q000503:physiopathology / Q000628:therapy*