Pre-flight evaluation of adult patients with cystic fibrosis: a cross-sectional study.
BACKGROUND
Air travel may imply a health hazard for patients with cystic fibrosis (CF) due to hypobaric environment in the aircraft cabin. The objective was to identify pre-flight variables, which might predict severe hypoxaemia in adult CF patients during air travel.


METHODS
Thirty adult CF-patients underwent pre-flight evaluation with spirometry, arterial oxygen tension (PaO2), pulse oximetry (SpO2) and cardiopulmonary exercise testing (CPET) at sea level (SL). The results were related to the PaO2obtained during a hypoxia-altitude simulation test (HAST) in which a cabin altitude of 2438 m (8000 ft) was simulated by breathing 15.1% oxygen.


RESULTS
Four patients fulfilled the criteria for supplemental oxygen during air travel (PaO2 HAST< 6.6 kPa). While walking slowly during HAST, another eleven patients dropped below PaO2 HAST6.6 kPa. Variables obtained during CPET (PaO2 CPET, SpO2 CPET, minute ventilation/carbon dioxide output, maximal oxygen uptake) showed the strongest correlation to PaO2 HAST.


CONCLUSIONS
Exercise testing might be of value for predicting in-flight hypoxaemia and thus the need for supplemental oxygen during air travel in CF patients. Trial registration The study is retrospectively listed in the ClinicalTrials.gov Protocol Registration System: NCT01569880 (date; 30/3/2012).
Department of Pulmonary Medicine, Oslo University Hospital, Ullevål, Oslo, Norway. elisabeth.edvardsen@nih.no.|Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. elisabeth.edvardsen@nih.no.
Elisabeth
http://orcid.org/0000-0002-9414-6638
E
Edvardsen
Department of Pulmonary Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
Aina
A
Akerø
Department of Pulmonary Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
Ole Henning
OH
Skjønsberg
Department of Pulmonary Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.|National Center for Cystic Fibrosis, Oslo University Hospital, Oslo, Norway.
Bjørn
B
Skrede
D000328:Adult; D000337:Aerospace Medicine / Q000379:methods*; D064870:Air Travel; D000401:Aircraft; D000531:Altitude; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D013147:Spirometry / Q000379:methods; D055815:Young Adult
D010100:Oxygen
Blood gas response; Cardiopulmonary exercise testing; Gas exchange; Hypoxia altitude simulation test; Pulmonary function