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Pre-flight assessment in patients with obesity hypoventilation syndrome.
MedLine Citation:
PMID:  25056376     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Reduced atmospheric pressure during air travel can cause significant hypoxaemia in some patients with respiratory disease. Our aims were to investigate the degree of hypoxaemia in patients with obesity hypoventilation syndrome (OHS) during hypoxic challenge test (HCT), and to identify any predictors of a positive HCT.
METHODS: Thirteen patients underwent assessment, including HCT, lung function and incremental shuttle walk test. All had OHS well controlled with long-term nocturnal non-invasive ventilation (NIV). Patients with chronic obstructive pulmonary disease were excluded. A positive HCT was defined according to the British Thoracic Society (BTS) recommendation as arterial oxygen tension (PaO2 ) <6.6 kPa and/or oxygen saturation <85%.
RESULTS: Mean age was 57 (± 11) years. Mean body mass index was 51.7 (± 12) kg/m(2) . Mean baseline PaO2 and arterial carbon dioxide tension (PaCO2 ) were 10.2 (9.5-11.3) kPa and 5.2 (3.7-6.8) kPa, respectively. Seven patients (54%) had a positive HCT. The correlation between baseline PaO2 and PaO2 at the end of the HCT was not statistically significant (r = 0.433, P = 0.184). A negative correlation was observed between baseline PaCO2 and PaO2 at the end of the HCT (r = -0.793, P = 0.004). A positive correlation was observed between the distance walked and the PaO2 at the end of the HCT (r = 0.608, P = 0.047).
CONCLUSIONS: OHS is a risk factor for severe hypoxaemia during air travel even if the ventilatory failure is well controlled. An HCT before air travel is advisable in all OHS patients. Those with positive HCT may use NIV or have oxygen on-board as per BTS recommendation.
Authors:
Masood Ali; Ian E Smith; Atul Gulati; John M Shneerson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-23
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Asian Pacific Society of Respirology.
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