Hypoxemia during air travel in patients with chronic obstructive pulmonary disease

Thomas A Dillard, B. W. Berg, K. R. Rajagopal, J. W. Dooley, W. J. Mehm

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Study Objective: To quantitate and identify determinants of the seversity of hypoxemia during air travel in patients with chronic obstructive pulmonary disease. Design: Prospective study of physiologic variables before and during intervention. Setting: Referral-based pulmonary disease clinic at a U.S. Army medical center. Patients: Eighteen ambulatory retired servicemen (age 68 ± 6 [SD] years) with severe chronic obstructive pulmonary disease (forced expiratory volume in the first second [FEV1] 31% ± 10% of predicted). Intervention: Altitude simulation equivalent to 2438 meters (8000 feet) above sea level in a hypobaric chamber. Measurements and Main Results: Radial artery catheter blood oxygen tension in the patients declined from a ground value (PaO2G) at sea level of 72.4 ± 9 mm Hg to an altitude value (PaO2Alt) of 47.4 ± 6 mm Hg after 45 minutes of steady state hypobaric exposure. The PaO2G correlated with PaO2Alt (r = 0.587; P < 0.01). Multiple regression analysis revealed that the preflight FEV1 reduced the variability in PaO2Alt not explained by PaO2G in the equation: PaO2Alt = 0.453 [PaO2G] + 0.386 [FEV1% predicted] + 2.440 (r = 0.847; P < 0.001). Residuals from two previously published formulas using PaO2G also correlated with FEV1 (r ≥ 0.765; P < 0.001). Conclusions: Arterial blood oxygen tension declined to clinically significant levels in most patients during hypobaric exposure. When combined with the preflight arterial PO2 at ground level (PaO2G), the measurement of the preflight FEV1 improved prediction of PaO2 at altitutde (PaO2Alt) in patients with severe chronic obstructive pulmonary disease.

Original languageEnglish (US)
Pages (from-to)362-367
Number of pages6
JournalAnnals of Internal Medicine
Volume111
Issue number5
DOIs
StatePublished - Jan 1 1989
Externally publishedYes

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Air Travel
Chronic Obstructive Pulmonary Disease
Oceans and Seas
Oxygen
Radial Artery
Forced Expiratory Volume
Lung Diseases
Referral and Consultation
Catheters
Regression Analysis
Hypoxia
Prospective Studies

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Dillard, T. A., Berg, B. W., Rajagopal, K. R., Dooley, J. W., & Mehm, W. J. (1989). Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine, 111(5), 362-367. https://doi.org/10.7326/0003-4819-111-5-362

Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. / Dillard, Thomas A; Berg, B. W.; Rajagopal, K. R.; Dooley, J. W.; Mehm, W. J.

In: Annals of Internal Medicine, Vol. 111, No. 5, 01.01.1989, p. 362-367.

Research output: Contribution to journalArticle

Dillard, TA, Berg, BW, Rajagopal, KR, Dooley, JW & Mehm, WJ 1989, 'Hypoxemia during air travel in patients with chronic obstructive pulmonary disease', Annals of Internal Medicine, vol. 111, no. 5, pp. 362-367. https://doi.org/10.7326/0003-4819-111-5-362
Dillard, Thomas A ; Berg, B. W. ; Rajagopal, K. R. ; Dooley, J. W. ; Mehm, W. J. / Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. In: Annals of Internal Medicine. 1989 ; Vol. 111, No. 5. pp. 362-367.
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abstract = "Study Objective: To quantitate and identify determinants of the seversity of hypoxemia during air travel in patients with chronic obstructive pulmonary disease. Design: Prospective study of physiologic variables before and during intervention. Setting: Referral-based pulmonary disease clinic at a U.S. Army medical center. Patients: Eighteen ambulatory retired servicemen (age 68 ± 6 [SD] years) with severe chronic obstructive pulmonary disease (forced expiratory volume in the first second [FEV1] 31{\%} ± 10{\%} of predicted). Intervention: Altitude simulation equivalent to 2438 meters (8000 feet) above sea level in a hypobaric chamber. Measurements and Main Results: Radial artery catheter blood oxygen tension in the patients declined from a ground value (PaO2G) at sea level of 72.4 ± 9 mm Hg to an altitude value (PaO2Alt) of 47.4 ± 6 mm Hg after 45 minutes of steady state hypobaric exposure. The PaO2G correlated with PaO2Alt (r = 0.587; P < 0.01). Multiple regression analysis revealed that the preflight FEV1 reduced the variability in PaO2Alt not explained by PaO2G in the equation: PaO2Alt = 0.453 [PaO2G] + 0.386 [FEV1{\%} predicted] + 2.440 (r = 0.847; P < 0.001). Residuals from two previously published formulas using PaO2G also correlated with FEV1 (r ≥ 0.765; P < 0.001). Conclusions: Arterial blood oxygen tension declined to clinically significant levels in most patients during hypobaric exposure. When combined with the preflight arterial PO2 at ground level (PaO2G), the measurement of the preflight FEV1 improved prediction of PaO2 at altitutde (PaO2Alt) in patients with severe chronic obstructive pulmonary disease.",
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