Authors:
Khanna M, Shackleton C, Verheggen M, Sharp M, Wilson AC, Hall GL
Authors notes:
Thorax. 2013:online
Keywords:
Hypoxia, air travel, preterm infants, pulse oxygen saturation, hypoxia challenge test
Abstract:
Up to a third of ex-preterm infants flying near term exhibit pulse oxygen saturation (SpO2) of less than 85% during air travel.
A hypoxia challenge test (HCT) is recommended to evaluate the requirement for in-flight supplemental O2.
The validity of the HCT in healthy, term infants has not been reported.
This study aimed to characterise the in-flight hypoxia response and the accuracy of the HCT to predict this response in healthy, term infants in the first year of life.
Infants underwent a HCT prior to commercial air travel during which parents monitored SpO2.
Thirty-two flights were undertaken with six infants completing multiple flights. The median in-flight SpO2 nadir was 87% and significantly lower than the HCT SpO2 nadir.
Infants on seven flights recorded SpO2<85% with one infant recording a HCT with a SpO2 less than 85%.
There was marked variability in the inflight SpO2 in the six infants who undertook multiple flights, and for three of these infants, the SpO2 nadir was both above and below 85%.
We report that in healthy term infants an in-flight SpO2 below 85% is common and can vary considerably between flights and that the HCT poorly predicts the risk of in-flight hypoxia.
As it is common for healthy term infants to have SpO2 less than 85% during air travel further research is needed to clarify whether this is an appropriate cut-off in this age group.