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Original Research: COPD |

COPD and Air TravelOxygen Supplementation During Air Travel: Oxygen Equipment and Preflight Titration of Supplemental Oxygen

Aina Akerø, MD; Anne Edvardsen, MSc; Carl C. Christensen, MD, PhD; Jan O. Owe, MD; Morten Ryg, PhD; Ole H. Skjønsberg, MD, PhD
Author and Funding Information

From the Department of Pulmonary Medicine (Drs Akerø and Skjønsberg), Oslo University Hospital, Oslo; The Institute of Aviation Medicine (Drs Christensen and Owe), Oslo; and the Department of Respiratory Physiology (Ms Edvardsen and Drs Christensen and Ryg), Glittreklinikken, Hakadal, Norway.

Correspondence to: Aina Akerø, MD, Department of Pulmonary Medicine, Oslo University Hospital Ullevål, 0407 Oslo, Norway; e-mail: aina.akero@medisin.uio.no


Funding/Support: The study was funded by the Department of Pulmonary Medicine, Oslo University Hospital Ullevål, and by funds from the Norwegian Foundation for Health and Rehabilitation.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(1):84-90. doi:10.1378/chest.10-0965
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Background:  Patients with COPD may need supplemental oxygen during air travel to avoid development of severe hypoxemia. The current study evaluated whether the hypoxia-altitude simulation test (HAST), in which patients breathe 15.1% oxygen simulating aircraft conditions, can be used to establish the optimal dose of supplemental oxygen. Also, the various types of oxygen-delivery equipment allowed for air travel were compared.

Methods:  In a randomized crossover trial, 16 patients with COPD were exposed to alveolar hypoxia: in a hypobaric chamber (HC) at 2,438 m (8,000 ft) and with a HAST. During both tests, supplemental oxygen was given by nasal cannula (NC) with (1) continuous flow, (2) an oxygen-conserving device, and (3) a portable oxygen concentrator (POC).

Results:  Pao2 kPa (mm Hg) while in the HC and during the HAST with supplemental oxygen at 2 L/min (pulse setting 2) on devices 1 to 3 was (1) 8.6 ± 1.0 (65 ± 8) vs 12.5 ± 2.4 (94 ± 18) (P < .001), (2) 8.6 ± 1.6 (64 ± 12) vs 9.7 ± 1.5 (73 ± 11) (P < .001), and (3) 7.7 ± 0.9 (58 ± 7) vs 8.2 ± 1.1 (62 ± 8) (P= .003), respectively.

Conclusions:  The HAST may be used to identify patients needing supplemental oxygen during air travel. However, oxygen titration using an NC during a HAST causes accumulation of oxygen within the facemask and underestimates the oxygen dose required. When comparing the various types of oxygen-delivery equipment in an HC at 2,438 m (8,000 ft), compressed gaseous oxygen with continuous flow or with an oxygen-conserving device resulted in the same Pao2, whereas a POC showed significantly lower Pao2 values.

Trial registry:  ClinicalTrials.gov; No.: Identifier: NCT01019538; URL: clinicaltrials.gov

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