Predicting hypoxaemia during flights in children with cystic fibrosis. Issue 11 (1st November 2001)

• Record Type: Journal Article
• Authors: Buchdahl, R M; Babiker, A; Bush, A; Cramer, D
• Is Part Of: Thorax. Volume 56:Issue 11(2001)
• Page Start: 877
• Page End: 879
• Publication Date: 2001-11-01
• Subjects: cystic fibrosis -- flying -- travel -- desaturation -- children; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax.56.11.877
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : BACKGROUND: We have previously suggested that it is possible to predict oxygen desaturation during flight in children with cystic fibrosis and chronic lung disease by non-invasive measurement of oxygen saturation following inhalation of 15% oxygen—the pre-flight hypoxic challenge. This study reports on the results of measurements over 5 years. METHODS: The study comprised a pre-flight hypoxic challenge measuring oxygen saturation by finger tip pulse oximetry (Spo 2 ) during tidal breathing of 15% oxygen in nitrogen and spirometric testing 1 month before the flight followed by Spo 2 measurements during intercontinental flights to and from holidays abroad with children in wake and sleep states. RESULTS: Pre-flight tests were completed on 87 children with cystic fibrosis. Desaturation of <90% occurred in 10 children at some stage during the flight, three of whom received supplementary oxygen. Using a cut off Spo 2 of 90%, the pre-flight hypoxic challenge correctly predicted desaturation in only two of these children. The sensitivity and specificity of the pre-flight hypoxic challenge were 20% and 99%, respectively, compared with 70% and 96% for spirometric tests (using a cut off for forced expiratory volume in 1 second (FEV1 ) of <50% predicted). Overall, pre-flight spirometric tests were a better predictor of desaturation during flight with the area under the Receiver Operating Characteristic (ROC) curve of 0.89 compared with 0.73 for the hypoxic challenge test. CONCLUSIONS: In this group of subjects pre-flight spirometric testing was a better predictor of desaturation during flight than the pre-flight hypoxic challenge.