TY - JOUR T1 - BTS recommendations for referral for hypoxic flight assessment are not appropriate in paediatrics JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 4334 AU - Patrick Jamieson AU - Colleen Carden Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/4334.abstract N2 - IntroductionThe assessment of paediatric hypoxia during commercial flight is not as well understood as the equivalent area in adults. The BTS recommends that patients with a baseline greater than 95% do not need a hypoxic flight assessment. This study examined the BTS criteria for referral for hypoxic flight assessment with respect to prevalence of hypoxia during this assessment, in a paediatric sample.MethodsThis was a retrospective audit of patients referred to a paediatric respiratory function laboratory. The test protocol used 100% nitrogen to dilute the contents of a body plethysmograph to a FiO2 of 15%, before assessing the SpO2 profile for 20 minutes. Failure of hypoxic challenge, according to BTS criteria, constituted a mean SpO2% of less than 90% when breathing FiO2 15%.Results107 children (58% female) age 0.1-19.2 years (mean 7.0, SD 5.4) were tested. They were referred for a variety of conditions including muscular dystrophy, cystic fibrosis, severe asthma, long term ventilation, long term oxygen therapy and sleep breathing disorders. 83% of patients referred had a baseline SpO2 in FiO2 21% of greater than 95%. 29% of these patients were determined to be hypoxic in FiO2 15%.ConclusionsIf BTS criteria for referral were applied to this patient sample, only 6% would be detected as hypoxic in FiO2 15%. When these criteria are not used then a total of 35% of these patients are found to be hypoxic. Either the BTS criteria for detecting hypoxia are too sensitive, or the BTS indications for hypoxic flight assessment are not specific enough. This study highlights the problems associated with predicting a patient's response to hypoxia using baseline measures. ER -