Document Detail

Hypoxemia during air travel in patients with chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  2764404     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To quantitate and identify determinants of the severity of hypoxemia during air travel in patients with chronic obstructive pulmonary disease. DESIGN: Prospective study of physiologic variables before and during intervention. SETTING: Referral-based pulmonary disease clinic at a U.S. Army medical center. PATIENTS: Eighteen ambulatory retired servicemen (age 68 +/- 6 [SD] years) with severe chronic obstructive pulmonary disease (forced expiratory volume in the first second [FEV1] 31% +/- 10% of predicted). INTERVENTION: Altitude simulation equivalent to 2438 meters (8000 feet) above sea level in a hypobaric chamber. MEASUREMENTS AND MAIN RESULTS: Radial artery catheter blood oxygen tension in the patients declined from a ground value (PaO2G) at sea level of 72.4 +/- 9 mm Hg to an altitude value (PaO2Alt) of 47.4 +/- 6 mm Hg after 45 minutes of steady state hypobaric exposure. The PaO2G correlated with PaO2Alt (r = 0.587; P less than 0.01). Multiple regression analysis revealed that the preflight FEV1 reduced the variability in PaO2Alt not explained by PaO2G in the equation: PaO2Alt = 0.453 [PaO2G] + 0.386 [FEV1% predicted] + 2.440 (r = 0.847; P less than 0.001). Residuals from two previously published formulas using PaO2G also correlated with FEV1 (r greater than or equal to 0.765; P less than 0.001). CONCLUSIONS: Arterial blood oxygen tension declined to clinically significant levels in most patients during hypobaric exposure. When combined with the preflight arterial PO2 at ground level (PaO2G), the measurement of the preflight FEV1 improved prediction of PaO2 at altitude (PaO2Alt) in patients with severe chronic obstructive pulmonary disease.
T A Dillard; B W Berg; K R Rajagopal; J W Dooley; W J Mehm
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  111     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-09-18     Completed Date:  1989-09-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  362-7     Citation Subset:  AIM; IM; S    
Walter Reed Army Medical Center, Washington, DC.
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MeSH Terms
Aerospace Medicine*
Anoxia / etiology*
Atmospheric Pressure
Forced Expiratory Volume
Lung Diseases, Obstructive / blood,  complications*,  physiopathology
Middle Aged
Prospective Studies
Regression Analysis
Comment In:
Ann Intern Med. 1990 Apr 1;112(7):547-8   [PMID:  2316944 ]
Ann Intern Med. 1990 Jan 15;112(2):147-8   [PMID:  2294822 ]

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