COPD and air travel: Does hypoxia-altitude simulation test predict in-flight respiratory symptoms?

The reduced pressure in the aircraft cabin may cause significant hypoxaemia and respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD). The current study evaluated whether there is a relationship between hypoxaemia obtained during hypoxia-altitude simulation testing (HAST), simulating 2438 m altitude, and the reporting of respiratory symptoms during air travel. Eighty-two patients with moderate to very severe COPD answered an air travel questionnaire. Arterial oxygen pressures during HAST (PaO 2 HAST ) in subjects with and without in-flight respiratory symptoms were compared. The same questionnaire was answered within one year after the HAST. Mean PaO 2 HAST was 6.3 (0.6) kPa, and 62 (76%) of the patients had PaO 2 HAST <6.6 kPa. Thirty-eight patients (46%) had experienced respiratory symptoms during air travel. There was no difference in PaO 2 HAST in those with and those without in-flight respiratory symptoms (6.3 (0.7) kPa vs. 6.3 (0.6) kPa, respectively, (p=0.93)). Fifty-four patients (66%) travelled by air after the HAST, and patients equipped with supplemental oxygen (n=23, 41%) reported less respiratory symptoms when flying with than without such treatment (4 (17%) vs. 11 (48%), p=0.04). In conclusion, no difference in PaO 2 HAST was found between COPD patients with and without respiratory symptoms during air travel.