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Original Research: Pulmonary Vascular Disease |

Effects of Commercial Air Travel on Patients With Pulmonary HypertensionAir Travel and Pulmonary Hypertension

Nareg Roubinian, MD, MPH; C. Gregory Elliott, MD, FCCP; Christopher F. Barnett, MD, MPH; Paul D. Blanc, MD, MSPH, FCCP; Joan Chen, BA; Teresa De Marco, MD; Hubert Chen, MD, MPH, FCCP
Author and Funding Information

From the Department of Medicine (Drs Roubinian, Barnett, Blanc, De Marco, and Chen and Ms Chen), University of California-San Francisco, San Francisco, CA; Genentech, Inc (Dr Chen), South San Francisco, CA; the Department of Medicine (Dr Elliott), University of Utah, Salt Lake City, UT; and the Department of Medicine (Dr Elliott), Intermountain Medical Center, Murray, UT.

Correspondence to: Nareg Roubinian, MD, MPH, University of California-San Francisco, Department of Medicine, 533 Parnassus Ave, Room U127, San Francisco, CA 94143; e-mail: Nareg.Roubinian@ucsfmedctr.org


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Funding/Support: This study was funded by The CHEST Foundation and by the National Institutes of Health [Grants T32 HL007185 (Dr Roubinian) and K23 HL086585 (Dr Chen)].


Chest. 2012;142(4):885-892. doi:10.1378/chest.11-2016
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Background:  Limited data are available on the effects of air travel in patients with pulmonary hypertension (PH), despite their risk of physiologic compromise. We sought to quantify the incidence and severity of hypoxemia experienced by people with PH during commercial air travel.

Methods:  We recruited 34 participants for a prospective observational study during which cabin pressure, oxygen saturation (Spo2), heart rate, and symptoms were documented serially at multiple predefined time points throughout commercial flights. Oxygen desaturation was defined as Spo2 < 85%.

Results:  Median flight duration was 3.6 h (range, 1.0-7.3 h). Mean ± SD cabin pressure at cruising altitude was equivalent to the pressure 1,968 ± 371 m (6,456 ± 1,218 ft) above sea level (ASL) (maximum altitude = 2,621 m [8,600 ft] ASL). Median change in Spo2 from sea level to cruising altitude was −4.9% (range, 2.0% to −15.8%). Nine subjects (26% [95% CI, 12%-38%]) experienced oxygen desaturation during flight (minimum Spo2 = 74%). Thirteen subjects (38%) reported symptoms during flight, of whom five also experienced desaturations. Oxygen desaturation was associated with cabin pressures equivalent to > 1,829 m (6,000 ft) ASL, ambulation, and flight duration (all P values < .05).

Conclusions:  Hypoxemia is common among people with PH traveling by air, occurring in one in four people studied. Hypoxemia was associated with lower cabin pressures, ambulation during flight, and longer flight duration. Patients with PH who will be traveling on flights of longer duration or who have a history of oxygen use, including nocturnal use only, should be evaluated for supplemental in-flight oxygen.

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