Traveling with oxygen aboard commercial air carriers
- James K Stoller, MD, MS
James K Stoller, MD, MS
- Section Editor — Chronic Obstructive Pulmonary Disease
- Jean Wall Bennett Professor of Medicine, Samson Global Leadership Academy Endowed Chair
- Cleveland Clinic Lerner College of Medicine
- Chairman, Education Institute, Cleveland Clinic
It is estimated that over 2.7 billion passengers travel by air each year . Flying at a high altitude can induce significant hypoxemia in patients with underlying lung disease, despite pressurization of airliner cabins. A large number of air travelers have underlying medical conditions, including pulmonary disease, and are at risk for adverse cardiopulmonary effects related to oxygen desaturation [2-5].
The evaluation of patients for potential in-flight hypoxemia and the prescription of supplemental oxygen for air travel are reviewed here. General assessment and counseling prior to air travel and the indications for and provision of long-term supplemental oxygen are discussed separately. (See "Assessment of adult patients for air travel" and "Long-term supplemental oxygen therapy".)
EFFECTS OF AIR TRAVEL
Medical events occur during air travel in approximately 1 of every 604 flights with close to 44,000 in-flight medical emergencies occurring per year . Changes in atmospheric pressure and oxygen tension may contribute to these events.
Physiology — As altitude increases, ambient air pressure decreases, leading to a decrease in the oxygen tension (also known as the partial pressure of oxygen) of inspired air. The inspired oxygen tension (PiO2) can be determined by the equation:
PiO2 = FiO2 x (Patm - PH2O)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- EFFECTS OF AIR TRAVEL
- SCREENING FOR IN-FLIGHT HYPOXEMIA
- Initial assessment with pulse oximetry
- Indications for further evaluation
- Methods for predicting in-flight hypoxemia
- - Regression equations
- - Hypoxia altitude simulation test
- - Hypobaric chamber
- Comparing methods
- DISEASE-SPECIFIC CONSIDERATIONS
- Cystic fibrosis
- Pulmonary hypertension
- Pulmonary lymphangioleiomyomatosis
- DETERMINING THE OXYGEN REQUIREMENT
- PRACTICAL CONSIDERATIONS
- TRAVELER RESOURCES
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS