air travel Flashcards
When is HCT considered for COPD patients?
resting SpO2 ≤95%, MRC score 3 or greater, or desaturation to <84% on 6MWT and concerns about hypercapnia
When is HCT considered for asthma patients?
severe asthma with persistent symptoms and/or freq exacerbations despite optimal treatment regardless of resting sea level SpO2
When is HCT considered for ILD patients?
SpO2 falls to <95% on exercise, and whose resting sea level PaO2 ≤9.42 kPa or whose TLCO ≤50%
may be reasonable to recommend 2L/ min without recourse to HCT
When is HCT considered for resp muscle weakness/chest wall deformity patients?
FVC <1 L
What is a positive HCT?
PaO2 <6.6kPa (<50mm Hg) or SpO2 <85%: in-flight oxygen recommended
When is HCT considered for CF patients?
FEV <50% predicted, oxygen needed if SpO2<90%
When can you fly post PTX?
one week post resolution
When can you fly post interventional bronch/EBUS?
one week post procedure
When is HCT considered for PAH patients?
NYHA class III and IV advised to have inflight oxygen- 2L if no risk of hypercapnia
Those on LTOT- DOUBLE oxygen flow rate for flight
what does a 50m walk test tell you?
Nothing- should be the 6 min walk or incremental SWT
But only tells you who needs an HCT/further eval
What is HCT?
15% oxygen mixture (simulates breathing at 8000ft) or 40%V with pure nitrogen gives 15% O2 mix for 20mins (reaches equilibrium)
physiological response to hypobaric hypoxia (PaO <8kPa) is increased ventilation
do not predict respiratory symptoms during air travel
PaO2 ≥6.6 kPa or SpO2 ≥85%: oxygen not required
PaO2 <6.6kPa or SpO2 <85%: oxygen needed. titrate oxygen to maintain PaO2 ≥6.6kPa or SpO2 ≥85% in adults
Consider advising against air travel if pH falls to <7.35 and PCO2 increases by > 1 kPa (7.5 mm Hg) from baseline when PaO2 is maintained at ≥ 6.6 kPa or SpO2 ≥85%
When is the earliest you should travel after VTE?
2 weeks after therapeutic treatment commenced
