Abstract
Background: Hypoxia is reported in preterm neonates during medical air transfer. Predicting in-flight hypoxia in preterm infants is difficult from available data.
Aims: Further investigate the response of preterm infants to flight, identify factors that may predict in-flight hypoxia and the need for in-flight oxygen.
Methods: A retrospective review of neonatal and in-flight data of all infants born <37 weeks gestation undertaking medical air transfer between 2005-2008. In-flight oxygen was commenced if oxygen saturation decreased to <85% for >2 minutes. The impact of post-menstrual age (PMA), birth weight, duration of ventilatory support/oxygen, demographics at time of flight and duration of flight on the need for in-flight oxygen was assessed by Mann-Whitney tests.
Results: 141 infants completed flights during the review period. The mean (range) PMA at birth and flight was 31.9 (24-36) weeks and 36.1 (33.1-47.6) w, respectively. In-flight, 43 required supplemental oxygen. PMA at birth and flight, birth weight, gender and duration and type of ventilatory support and oxygen did not differ between those infants that required in-flight O2. Paradoxically, infants requiring in-flight oxygen (n=43) were heavier at the time of flight (p=0.024) and undertook shorter flights (p=0.001).
Conclusion: A significant proportion of preterm infants require oxygen in the immediate post-natal period during air travel. In this analysis a requirement for oxygen could not be predicted by a range of neonatal outcomes. Neonatal units considering medical transfers of preterm infants should include options for in-flight oxygen to be available for these infants. Further research is required to understand the responses of young infants to air travel.
- © 2011 ERS