PURPOSE: To investigate, in light of the absence of scientific evidence, Thoracic Surgeons’ recommendations with regard to air travel by patients with pneumothorax (PTX) and/or pneumomediastinum (PMED) following thoracic surgery.
METHODS: A questionnaire was distributed at the 2006 General Thoracic Surgical Club meeting attended by 127 thoracic surgeons; seven questions asked details of when a patient with PTX and/or MED would be allowed to fly after thoracic surgery.
RESULTS: Seventy four questionnaires were returned. Fifty three percent of surgeons asked patients to wait several days (median of 7.8 days; up to 60 days) after complete resolution of PTX prior to air travel. On the other hand, in the case of mediastinoscopy, 80 % of surgeons allowed their patients to fly right away, even if they had PMED; the other surgeons advised their patients with PMED not to fly for a median of 3 days (up to 30 days). Patients were asked to delay air travel up to 5 times a year (median of 0) for PMED and up to 50 times a year (median of 2) for PTX, delaying their travel by up to 45 days (median of 0) and by up to 90 days (median of 7), respectively. The only adverse in-flight events reported were 2 cases of thoracic pain during ascent.
CONCLUSION: A wide variability exists among Thoracic Surgeons with regard to recommendations for air travel by patients with PTX and/or PMED after thoracic surgery. Airlines advise a 2-4 week interval between radiographic resolution of a PTX and air travel; however, almost half of the Surgeons allow their patients to fly with PTX, depending on its size. Both the surgeons’ recommendations and the airline guidelines are arbitrary, based on weekly intervals, but lacking any scientific evidence.
CLINICAL IMPLICATIONS: Animal studies of PTX and PMED expansion during hypobaric exposures simulating aircraft ambient pressure could lead to more rational guidelines, with major financial and practical implications related to delay in air travel.
DISCLOSURE: Gary Mullen, No Financial Disclosure Information; No Product/Research Disclosure Information