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Hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight

¹ Dept of Pulmonary Medicine, Ullevål University Hospital, Oslo, and ² Glittreklinikken, Hakadal, Norway

CORRESPONDENCE: A. Akerø, Dept of Pulmonary Medicine, Ullevål University Hospital, 0407 Oslo, Norway. Fax: 47 23015963. E-mail: aina.akero@uus.no

Keywords: Altitude, cabin pressure, chronic obstructive pulmonary disease, commercial aircraft, hypoxaemia

Received: August 9, 2004
Accepted November 19, 2004

The aim of the study was to investigate hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight.

The effect of a commercial flight, lasting 5 h 40 min, on arterial blood gas levels and symptoms in 18 chronic obstructive pulmonary disease patients with a pre-flight percutaneous oxygen saturation of 94% and self-reported ability to walk 50 m without severe dyspnoea was studied.

The arterial oxygen tension (P_a,O2) decreased from sea level to cruising altitude (10.3±1.2 versus 8.6±0.8 kPa), but, thereafter, except for one patient, remained stable throughout the flight. During light exercise, however, there was further desaturation (percutaneous oxygen saturation 90±4 versus 87±4%). After 4 h, a decrease in arterial carbon dioxide tension (5.0±0.4 versus 4.8±0.4 kPa) and an increase in cardiac frequency (87±13 versus 95±13 beats·min^-1) were observed. A pre-flight P_a,O2 of >9.3 kPa did not secure an acceptable in-flight P_a,O2. Aerobic capacity showed the strongest correlation with in-flight P_a,O2.

In conclusion, following an initial decrease in arterial oxygen tension, chronic obstructive pulmonary disease patients in a stable state of their disease seem to maintain a stable arterial oxygen tension throughout a flight of intermediate duration, except when walking along the aisle. However, a decrease in arterial carbon dioxide tension, indicating compensatory hyperventilation, could imply a risk of respiratory fatigue during longer flights.

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