Our approach to assessing supplemental oxygen requirements during air travel in patients with chronic cardiopulmonary disease*

This figure summarizes the approach to evaluation of supplemental oxygen requirements during air travel in patients with chronic stable lung disease, primarily COPD. Data are sparse for patients with interstitial lung disease or restriction. Refer to UpToDate topic(s) on evaluation of patients for supplemental oxygen for air travel for additional details.

SpO₂: pulse oxygen saturation; 6MWT: 6 minute walk test; HAST: hypoxia altitude simulation test, also called hypoxic challenge test; PaO₂: arterial partial pressure of oxygen; COPD: chronic obstructive pulmonary disease; FAA: Federal Aviation Administration; POC: portable oxygen concentrator; FiO₂: fraction of inspired oxygen; PaCO₂: arterial tension of carbon dioxide; CO₂: carbon dioxide.

* For most patients, an FAA-approved, battery-powered POC is used to provide supplemental oxygen in flight. Refer to UpToDate content regarding prescription of in-flight oxygen.

¶ HAST involves inhalation of gas mixed to an FiO₂ of 15.1% for 20 minutes to simulate an altitude of 8000 feet (2438 meters). HAST may not be covered by medical insurance. Refer to UpToDate content regarding specifics of testing and monitoring.

Δ During HAST, SpO₂ has a good but not perfect correlation with PaO₂; assessment of PaO₂ is preferred if available.

◊ HAST is less accurate than hypobaric testing but more readily available. Determining exact supplemental oxygen requirement during HAST is technically difficult and may underestimate supplemental oxygen requirements. PaCO₂ or end-tidal CO₂ should be assessed during supplemental oxygen administration in patients with prior or current hypercapnia.

Graphic 121049 Version 4.0

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Our approach to assessing supplemental oxygen requirements during air travel in patients with chronic cardiopulmonary disease*