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Hypoxic Challenge Testing for Fitness to Fly with Severe Asthma.

Aerosp Med Hum Perform. 2016;87(6):571-574

Authors: George PM, Orton C, Ward S, Menzies-Gow A, Hull JH

Abstract
INTRODUCTION: Commercial airline travel poses a recognized risk to patients with respiratory disease, including in those with asthma. Hypoxic challenge testing (HCT) is typically employed to mitigate this risk by dictating in-flight oxygen requirement.
METHODS: The role of HCT has not been formally studied in patients with severe asthma and we therefore evaluated HCT assessment in a cohort of patients with severe asthma (N = 37).
RESULTS: Over half (57%) of patients had a positive HCT. Baseline oxygen saturation (Spo2) was poorly predictive of a recommendation for supplementary oxygen in flight; two-thirds of those deemed to require oxygen had a baseline Spo2 > 95%. A combination of any two of: Pao2 ? 10.5 kPa, FEV1 ? 60% predicted, and PEF ? 350 L · min(-1) predicted the need for in-flight oxygen with a sensitivity of 89% and a specificity of 69%. Furthermore, no patient with an Spo2 > 95% and FEV1 > 85% predicted had a positive HCT.
CONCLUSION: Overall, the findings indicate that HCT should be considered for all patients with severe asthma, regardless of resting oxygen saturation level. George PM, Orton C, Ward S, Menzies-Gow A, Hull JH. Hypoxic challenge testing for fitness to fly with severe asthma. Aerosp Med Hum Perform. 2016; 87(6):571-574.

PMID: 27208681 [PubMed – as supplied by publisher]

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