HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Fischer, R. Articles by Huber, R. M. Search for Related Content PubMed PubMed Citation Articles by Fischer, R. Articles by Huber, R. M.

Lung function in adults with cystic fibrosis at altitude: impact on air travel

¹ Dept of Medicine, Division of Pneumology, Clinic for Internal Medicine, and ³ Dept of Paediatrics, Dr. von Hauner's Children's Hospital, University of Munich, Munich, and ² Clinic Bad Reichenhall, Bad Reichenhall, Germany

CORRESPONDENCE: R. Fischer, Pneumology, Medizinische Klinik Innenstadt, University of Munich, Ziemssenstr. 1, D-80336 München, Germany. Fax: 49 8951604905. E-mail: rainald.fischer@med.uni-muenchen.de

Keywords: Air travel, cystic fibrosis, exercise, guidelines, hypoxia

Received: July 24, 2004
Accepted November 6, 2004

Current guidelines for air travel state that patients with chronic respiratory diseases are required to use oxygen if their in-flight arterial oxygen tensions (P_a,O2) drop below 6.6 kPa. This recommendation may not be strictly applicable to cystic fibrosis patients, who may tolerate lower P_a,O2 for several hours without clinical symptoms.

Lung function, symptoms, blood gas levels and signs of pulmonary hypertension were studied in 36 cystic fibrosis patients at altitudes of 530 m and, after 7 h, 2,650 m. A hypoxia inhalation test (inspiratory oxygen fraction 0.15) was performed at low altitude in order to predict high-altitude hypoxaemia.

Median P_a,O2 dropped from 9.8 kPa at low altitude to 7.0 kPa at high altitude. Mild exercise at a workload of 30 W further decreased P_a,O2. Two-thirds of all patients exhibited P_a,O2 of <6.6 kPa during exercise and, except for one patient, were asymptomatic. Patients were significantly less obstructed at an altitude of 2,650 m. Low forced expiratory volume in one second at baseline was associated with a low P_a,O2 at altitude.

It is concluded that cystic fibrosis patients with baseline arterial oxygen tensions of >8.0 kPa safely tolerate an altitude of 2,650 m for several hours under resting conditions. The risk assessment of low in-flight oxygenation should encompass the whole clinical situation of cystic fibrosis patients, with special attention being paid to the presence of severe airway obstruction.

This article has been cited by other articles:

				R. K. Coker, R. J. Shiner, and M. R. Partridge Is air travel safe for those with lung disease? Eur. Respir. J., December 1, 2007; 30(6): 1057 - 1063. [Abstract] [Full Text] [PDF]

				S.E. Martin, J.M. Bradley, J.B. Buick, I. Bradbury, and J.S. Elborn Flight assessment in patients with respiratory disease: hypoxic challenge testing vs. predictive equations QJM, June 1, 2007; 100(6): 361 - 367. [Abstract] [Full Text] [PDF]

				A. M. Luks and E. R. Swenson Travel to high altitude with pre-existing lung disease Eur. Respir. J., April 1, 2007; 29(4): 770 - 792. [Abstract] [Full Text] [PDF]

				D S Urquhart, H Montgomery, and A Jaffe Assessment of hypoxia in children with cystic fibrosis Arch. Dis. Child., November 1, 2005; 90(11): 1138 - 1143. [Abstract] [Full Text] [PDF]