Altitude-related hypoxia: Risk assessment and management for passengers on commerical aircraft

Aviation Space and Environmental Medicine

Volumn 74, Issue 9, 2003, Pages 922-927

  Mortazavi, Amir ^a   Eisenberg, Mark J ^b   Langleben, David ^b   Ernst, Pierre ^c   Schiff, Renee L ^a,d  

^a MCGILL UNIVERSITY   (Canada)

^b MCGILL UNIVERSITY   (Canada)

^c MCGILL UNIVERSITY HEALTH CENTRE   (Canada)

^d ROYAL VICTORIA HOSPITAL   (Canada)

Author keywords

Air travel; Altitude; Barometric pressure; COPD; Hypoxemia; Hypoxia; Oxygen

Indexed keywords

AIRCRAFT; ALTITUDE; ALTITUDE DISEASE; AVIATION; BLOOD GAS; HEART DISEASE; HUMAN; HYPERVENTILATION; HYPOBARISM; HYPOXIA; LUNG DISEASE; LUNG VASOCONSTRICTION; LUNG VENTILATION PERFUSION RATIO; OXYGEN SATURATION; OXYGEN TENSION; PRACTICE GUIDELINE; REVIEW; RISK ASSESSMENT; RISK MANAGEMENT; SYMPATHETIC TONE;

AEROSPACE MEDICINE; ALTITUDE SICKNESS; AVIATION; CANADA; CARDIOVASCULAR DISEASES; COMORBIDITY; CYSTIC FIBROSIS; HUMANS; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE; REGRESSION ANALYSIS; RISK ASSESSMENT; RISK FACTORS; RISK MANAGEMENT;

EID: 0042337390     PISSN: 00956562     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (41)

1. Alexander J. Coronary problems associated with air travel. Cardiol Clin 1995; 13:271-8.
2. AMA Commission On Emergency Medical Services. Medical aspects of transportation aboard commercial aircrafts. JAMA 1982; 247:1007-11.
3. Bendrick GA, Nicolas DK, Krause BA, Castillo CY. Inflight oxygen saturation decrements in aeromediacal evacuation patients. Aviat Space Environ Med 1995; 66:40-4.
4. Christensen CC, Ryg M, Refvem OK, Skjønsberg OH. Development of severe hypoxemia in chronic obstructive pulmonary disease patients at 2,438 m (8,000 ft) altitude. Eur Respir J 2000; 15:635-9.
5. Coker RK, Partridge MR. Assessing, the risk of hypoxia in flight: the need for more rational guidelines. Eur Resp J 2000;15:128-30.
6. Cottrell JJ. Altitude exposures during aircraft flight. Chest 1988; 93:81-4.
7. Cox GR, Peterson J, Bouchel L, Delmas JJ. Safety of commercial air travel following myocardial infarction. Aviat Space Environ Med 1996; 67:976-82.
8. Crystal RG, West JB, Barnes PJ, et al. The lung. New York: Raven Press Ltd.; 1997:2653-63.
9. Cummins RO, Schubach JA. Frequency and types of medical emergencies among commercial air travelers. JAMA 1989; 261: 1295-9.
10. Dillard TA, Berg BW, Rajagopal KR, et al. Hypoxia during air travel in patients with COPD. Ann Intern Med 1989; 111:362-7.
11. Dillard TA, Rosenberg AP, Berg BW. Hypoxemia during altitude exposure. Chest 1993; 103:422-5.
12. Dillard TA, Moores LK, Bilello KL, Phillips YY. The preflight evaluation: A comparison of the hypoxia inhalation test with hypobaric exposure. Chest 1995; 107:352-7.
13. Dillard TA, Ewald F Jr. The use of pulmonary function testing in piloting, air travel, mountain climbing, and diving. Clin Chest Med 2001; 22:795-816.
14. Essebag V, Lutchmedial S, Churchill-Smith M. Safety of long distance aeromedical transport of the cardiac patient: a retrospective study. Aviat Space Environ Med 2001; 72:182-7.
15. FAA regulations 14CFR 25.1443. Washington, DC: FAA; Rule effective 02/01/1965.
16. FAA regulations 14CFR 91.211. Washington, DC: FAA; Rule effective 09/30/1963.
17. FAA regulations 14CFR 121.327-333. Washington, DC: FAA; Rule effective 04/01/1965.
18. FAA regulations 14CFR 135.157. Washington, DC: FAA; Rule effective 12/01/1978.
19. Freitas J, Costa O, Carvalho MJ, Falcao de Freitas A. High altitude-related neurocardiogenic syncope. Am J Cardiol 1996; 77:1021.
20. Gendreau MA, DeJohn C. Responding to medical events during commercial airline flights. N Engl J Med 2002; 346:1067-73.
21. Gong H, Tashkin DP, Lee EY, et al. Hypoxia-altitude stimulation test. Am Rev Respir Dis 1984; 130:980-6.
22. Gong H. Air travel and oxygen therapy in cardiopulmonary patients. Chest 1992; 101:1104-13.
23. Jagoda A, Pietrzak M. Medical emergencies in commercial air travel. Emerg Med Clin North Am 1997; 251-9.
24. Kinsella SM, Tuckey JP. Perioperative bradycardia and asystole: relationship to vasovagal syncope and the Bezold-Jarisch reflex. Br J Anaesthesia 2001; 86:859-68.
25. Managing passengers with respiratory disease planning air travel: British Thoracic Society recommendations. Thorax 2002; 57:289-304.
26. Medical guidelines for Air Travel. Aviat Space and Environ Med 1996; 67:B1-B16.
27. Murray JF, Nadel JA. High altitude. In: Textbook of respirology medicine, 2nd ed. Philadelphia: W.B. Saunders Co.; 1992;2062-99.
28. Noble JS, Davidson JA. Cor pulmonale presenting in a patient with congenital kyphoscoliosis following intercontinental air travel. Anaesthesia 1999; 54:361-363.
29. Phillips BA, McConnell JW, Smith MD, Moffett C. The effects of hypoxemia on cardiac output. Chest 1988; 93:471-475.
30. Robson AG, Hartung TK, Innes JA. Laboratory assessment of fitness to fly in patients with lung disease: a practical approach. Eur Respir J 2000; 16:214-219.
31. Roby H, Lee A, Hopkins A. Safety of air travel following acute myocardial infarction. Aviat Space Environ Med 2002; 73:91-6.
32. Ryan T, Antman EM, Brooks NH, et al. ACC/AHA Guidelines for the management of patients with acute myocardial infaction: 1999 update. Section VII: Long term management. Bethesda, MD: American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction); 1999. Retrieved 20 November 2002 from www.acc.org/clinical/guidelines/nov96/edits/dirindex.htm.
33. Select Committee on Science, and Technology. Air travel and health: fifth report. London: United Kingdom House of Lords, 15 November 2000.
34. Skjenna OW, Evans JF, Morre MS, et al. Helping patients travel by air. CMAJ 1991; 144:287-293.
35. Speizer C, Rennie CJ, Breton H. Prevalence of inflight medical emergencies on commercial airlines. Ann Emerg Med 1989; 18:26-29.
36. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease; COPD and air travel. Am J Respir Crit Care Med 1995; 152:s112.
37. Stoller JK, Hoisington E, Auger G. A comparative analysis of arranging in-flight oxygen aboard commercial air carriers. Chest 1999; 115:991-5.
38. Ward MP, Milledge JS, West JB. High altitude medicine and physiology. Philadelphia, PA: University of Pennsylvania Press; 1989.
39. Wesl JB, Wagner PD. Predicted gas exchange on the summit of Mt. Everest. Respir Physiol 1980; 42:1-16.
40. Westendorp RG, Blauw GJ, Frölich M, Simons R. Hypoxic syncope. Aviat Space Environ Med 1997; 68:410-4.
41. Zahger D, Leibowitz D, Tabb IK, Weiss AT. Long-distance air travel soon after acute coronary syndrome: a prospective analysis of a triage protocol. Am Heart J 2000; 140:241-2.