Hypoxic Challenge Testing for Fitness to Fly with Severe Asthma

Commercial airline travel poses a recognized risk to patients with respiratory disease, including in those with asthma. Hypoxic challenge testing (HCT) is typically employed to mitigate this risk by dictating in-flight oxygen requirement. The role of HCT has not been formally studied in patients with severe asthma and the authors therefore evaluated HCT assessment in a cohort of patients with severe asthma (N = 37). Over half (57%) of patients had a positive HCT. Baseline oxygen saturation (Spo2) was poorly predictive of a recommendation for supplementary oxygen in flight; two-thirds of those deemed to require oxygen had a baseline Spo2 > 95%. A combination of any two of: Pao2 ≤ 10.5 kPa, FEV1 ≤ 60% predicted, and PEF ≤ 350 L · min−1 predicted the need for in-flight oxygen with a sensitivity of 89% and a specificity of 69%. Furthermore, no patient with an Spo2 > 95% and FEV1 > 85% predicted had a positive HCT. Overall, the findings indicate that HCT should be considered for all patients with severe asthma, regardless of resting oxygen saturation level.


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  • Accession Number: 01601888
  • Record Type: Publication
  • Files: TRIS
  • Created Date: May 31 2016 4:59PM