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Chest. 2011 Jul;140(1):84-90. doi: 10.1378/chest.10-0965. Epub 2010 Nov 11.

COPD and air travel: oxygen equipment and preflight titration of supplemental oxygen.

Author information

1
Department of Pulmonary Medicine, Oslo University Hospital, Oslo. Electronic address: aina.akero@medisin.uio.no.
2
Department of Respiratory Physiology, Glittreklinikken, Hakadal, Norway.
3
The Institute of Aviation Medicine, Oslo; Department of Respiratory Physiology, Glittreklinikken, Hakadal, Norway.
4
The Institute of Aviation Medicine, Oslo.
5
Department of Pulmonary Medicine, Oslo University Hospital, Oslo.

Abstract

BACKGROUND:

Patients with COPD may need supplemental oxygen during air travel to avoid development of severe hypoxemia. The current study evaluated whether the hypoxia-altitude simulation test (HAST), in which patients breathe 15.1% oxygen simulating aircraft conditions, can be used to establish the optimal dose of supplemental oxygen. Also, the various types of oxygen-delivery equipment allowed for air travel were compared.

METHODS:

In a randomized crossover trial, 16 patients with COPD were exposed to alveolar hypoxia: in a hypobaric chamber (HC) at 2,438 m (8,000 ft) and with a HAST. During both tests, supplemental oxygen was given by nasal cannula (NC) with (1) continuous flow, (2) an oxygen-conserving device, and (3) a portable oxygen concentrator (POC).

RESULTS:

PaO(2) kPa (mm Hg) while in the HC and during the HAST with supplemental oxygen at 2 L/min (pulse setting 2) on devices 1 to 3 was (1) 8.6 ± 1.0 (65 ± 8) vs 12.5 ± 2.4 (94 ± 18) (P < .001), (2) 8.6 ± 1.6 (64 ± 12) vs 9.7 ± 1.5 (73 ± 11) (P < .001), and (3) 7.7 ± 0.9 (58 ± 7) vs 8.2 ± 1.1 (62 ± 8) (P= .003), respectively.

CONCLUSIONS:

The HAST may be used to identify patients needing supplemental oxygen during air travel. However, oxygen titration using an NC during a HAST causes accumulation of oxygen within the facemask and underestimates the oxygen dose required. When comparing the various types of oxygen-delivery equipment in an HC at 2,438 m (8,000 ft), compressed gaseous oxygen with continuous flow or with an oxygen-conserving device resulted in the same PaO(2), whereas a POC showed significantly lower PaO(2) values.

TRIAL REGISTRY:

ClinicalTrials.gov; No.: Identifier: NCT01019538; URL: clinicaltrials.gov.

PMID:
21071527
DOI:
10.1378/chest.10-0965
[Indexed for MEDLINE]

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