Abstract | BACKGROUND: Patients with COPD may need supplemental oxygen during air travel to avoid development of severe hypoxemia. The current study evaluated whether the hypoxia-altitude simulation test (HAST), in which patients breathe 15.1% oxygen simulating aircraft conditions, can be used to establish the optimal dose of supplemental oxygen. Also, the various types of oxygen-delivery equipment allowed for air travel were compared. METHODS: In a randomized crossover trial, 16 patients with COPD were exposed to alveolar hypoxia: in a hypobaric chamber (HC) at 2,438 m (8,000 ft) and with a HAST. During both tests, supplemental oxygen was given by nasal cannula (NC) with (1) continuous flow, (2) an oxygen-conserving device, and (3) a portable oxygen concentrator (POC). RESULTS: PaO(2) kPa (mm Hg) while in the HC and during the HAST with supplemental oxygen at 2 L/min (pulse setting 2) on devices 1 to 3 was (1) 8.6 ± 1.0 (65 ± 8) vs 12.5 ± 2.4 (94 ± 18) (P < .001), (2) 8.6 ± 1.6 (64 ± 12) vs 9.7 ± 1.5 (73 ± 11) (P < .001), and (3) 7.7 ± 0.9 (58 ± 7) vs 8.2 ± 1.1 (62 ± 8) (P= .003), respectively. CONCLUSIONS: The HAST may be used to identify patients needing supplemental oxygen during air travel. However, oxygen titration using an NC during a HAST causes accumulation of oxygen within the facemask and underestimates the oxygen dose required. When comparing the various types of oxygen-delivery equipment in an HC at 2,438 m (8,000 ft), compressed gaseous oxygen with continuous flow or with an oxygen-conserving device resulted in the same PaO(2), whereas a POC showed significantly lower PaO(2) values. TRIAL REGISTRY: ClinicalTrials.gov; No.: Identifier: NCT01019538; URL: clinicaltrials.gov.
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Authors | Aina Akerø, Anne Edvardsen, Carl C Christensen, Jan O Owe, Morten Ryg, Ole H Skjønsberg |
Journal | Chest
(Chest)
Vol. 140
Issue 1
Pg. 84-90
(Jul 2011)
ISSN: 1931-3543 [Electronic] United States |
PMID | 21071527
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Aged
- Aircraft
- Cross-Over Studies
- Dose-Response Relationship, Drug
- Equipment Design
- Female
- Humans
- Hypoxia
(etiology, prevention & control)
- Male
- Middle Aged
- Oxygen
(administration & dosage)
- Oxygen Inhalation Therapy
(instrumentation)
- Pulmonary Disease, Chronic Obstructive
(complications, therapy)
- Travel
- Treatment Outcome
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