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Traveling with oxygen aboard commercial air carriers

James K Stoller, MD, MS
Section Editor
Peter J Barnes, DM, DSc, FRCP, FRS
Deputy Editor
Helen Hollingsworth, MD


It is estimated that over 2.7 billion passengers travel by air each year [1]. 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".)


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 [6]. 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)


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Literature review current through: Sep 2016. | This topic last updated: Sep 16, 2016.
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