A Akerø, E Edvardsen, P L Finstad, B Skrede, M Østerhaug, S Backman, A Edvardsen, O H Skjønsberg
{"title":"航空旅行和囊性纤维化：一种评估飞行中低氧血症风险的算法。","authors":"A Akerø, E Edvardsen, P L Finstad, B Skrede, M Østerhaug, S Backman, A Edvardsen, O H Skjønsberg","doi":"10.1016/j.jcf.2025.05.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Air travel may cause significant hypoxemia in patients with cystic fibrosis (CF). A pre-flight algorithm has previously been validated for patients with chronic obstructive pulmonary disease (COPD). No such tools are available for CF patients. The aim of this study was to evaluate if the pre-flight algorithm for COPD patients can be used by CF patients.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, oxygen saturation at sea level (SpO<sub>2 SL</sub>) and during exercise (SpO<sub>2 6MWT</sub>) were used to evaluate whether CF patients a) are fit for flight without further assessment, b) require in-flight supplemental oxygen, or c) need further evaluation with hypoxia-altitude simulation test (HAST). HAST was used as reference method, and SpO<sub>2 HAST</sub> ≤85 % was the criterion for recommending in-flight supplemental oxygen.</p><p><strong>Results: </strong>79 CF patients (41 men), age 38.0 ± 13.4 years, with FEV<sub>1</sub> of 71±23 % of predicted underwent HAST (SpO<sub>2 HAST</sub> 89.2 ± 4.0 %). Categories for SpO<sub>2 SL</sub> were >95 % (N = 53), 92-95 % (N = 25), and <92 %, (N = 1), and the cut-off value for SpO<sub>2 6MWT</sub> was <84 %. HAST showed that CF patients with SpO<sub>2 SL</sub> >95 % combined with SpO<sub>2 6MWT</sub> ≥84 % can travel by air without further assessment. Supplemental oxygen is recommended if SpO<sub>2 SL</sub> is 92-95 % combined with SpO<sub>2 6MWT</sub> <84 %, or if SpO<sub>2 SL</sub><92 %. Otherwise, HAST should be performed. Only 21 patients (27 %) would have needed referral to HAST. The algorithm correctly identified those who needed and those did not need in-flight supplemental oxygen.</p><p><strong>Conclusions: </strong>The algorithm for COPD patients may be used in the pre-flight evaluation of adult CF patients.</p><p><strong>Clinicaltrials: </strong>gov (NCT03843723).</p>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Air travel and cystic fibrosis: An algorithm to assess the risk of In-Flight Hypoxemia.\",\"authors\":\"A Akerø, E Edvardsen, P L Finstad, B Skrede, M Østerhaug, S Backman, A Edvardsen, O H Skjønsberg\",\"doi\":\"10.1016/j.jcf.2025.05.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Air travel may cause significant hypoxemia in patients with cystic fibrosis (CF). A pre-flight algorithm has previously been validated for patients with chronic obstructive pulmonary disease (COPD). No such tools are available for CF patients. The aim of this study was to evaluate if the pre-flight algorithm for COPD patients can be used by CF patients.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, oxygen saturation at sea level (SpO<sub>2 SL</sub>) and during exercise (SpO<sub>2 6MWT</sub>) were used to evaluate whether CF patients a) are fit for flight without further assessment, b) require in-flight supplemental oxygen, or c) need further evaluation with hypoxia-altitude simulation test (HAST). HAST was used as reference method, and SpO<sub>2 HAST</sub> ≤85 % was the criterion for recommending in-flight supplemental oxygen.</p><p><strong>Results: </strong>79 CF patients (41 men), age 38.0 ± 13.4 years, with FEV<sub>1</sub> of 71±23 % of predicted underwent HAST (SpO<sub>2 HAST</sub> 89.2 ± 4.0 %). Categories for SpO<sub>2 SL</sub> were >95 % (N = 53), 92-95 % (N = 25), and <92 %, (N = 1), and the cut-off value for SpO<sub>2 6MWT</sub> was <84 %. HAST showed that CF patients with SpO<sub>2 SL</sub> >95 % combined with SpO<sub>2 6MWT</sub> ≥84 % can travel by air without further assessment. Supplemental oxygen is recommended if SpO<sub>2 SL</sub> is 92-95 % combined with SpO<sub>2 6MWT</sub> <84 %, or if SpO<sub>2 SL</sub><92 %. Otherwise, HAST should be performed. Only 21 patients (27 %) would have needed referral to HAST. The algorithm correctly identified those who needed and those did not need in-flight supplemental oxygen.</p><p><strong>Conclusions: </strong>The algorithm for COPD patients may be used in the pre-flight evaluation of adult CF patients.</p><p><strong>Clinicaltrials: </strong>gov (NCT03843723).</p>\",\"PeriodicalId\":15452,\"journal\":{\"name\":\"Journal of Cystic Fibrosis\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cystic Fibrosis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jcf.2025.05.004\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cystic Fibrosis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jcf.2025.05.004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Air travel and cystic fibrosis: An algorithm to assess the risk of In-Flight Hypoxemia.
Background: Air travel may cause significant hypoxemia in patients with cystic fibrosis (CF). A pre-flight algorithm has previously been validated for patients with chronic obstructive pulmonary disease (COPD). No such tools are available for CF patients. The aim of this study was to evaluate if the pre-flight algorithm for COPD patients can be used by CF patients.
Methods: In this prospective cross-sectional study, oxygen saturation at sea level (SpO2 SL) and during exercise (SpO2 6MWT) were used to evaluate whether CF patients a) are fit for flight without further assessment, b) require in-flight supplemental oxygen, or c) need further evaluation with hypoxia-altitude simulation test (HAST). HAST was used as reference method, and SpO2 HAST ≤85 % was the criterion for recommending in-flight supplemental oxygen.
Results: 79 CF patients (41 men), age 38.0 ± 13.4 years, with FEV1 of 71±23 % of predicted underwent HAST (SpO2 HAST 89.2 ± 4.0 %). Categories for SpO2 SL were >95 % (N = 53), 92-95 % (N = 25), and <92 %, (N = 1), and the cut-off value for SpO2 6MWT was <84 %. HAST showed that CF patients with SpO2 SL >95 % combined with SpO2 6MWT ≥84 % can travel by air without further assessment. Supplemental oxygen is recommended if SpO2 SL is 92-95 % combined with SpO2 6MWT <84 %, or if SpO2 SL<92 %. Otherwise, HAST should be performed. Only 21 patients (27 %) would have needed referral to HAST. The algorithm correctly identified those who needed and those did not need in-flight supplemental oxygen.
Conclusions: The algorithm for COPD patients may be used in the pre-flight evaluation of adult CF patients.
期刊介绍：
The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.
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