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.
Kelly
Paul T
PT
Respiratory Physiology Laboratory, Christchurch Hospital, Christchurch, New Zealand. paul.kelly@cdhb.govt.nz
Hlavac
Michael
M
Beckert
Lutz E
LE
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*