About The Hypoxia Challenge Test Does Not Accurately Predict Hypoxia in Flight in Ex-Preterm Neonates
While air travel is a popular form of travel, with approximately 25,000 commercial flights departing from and arriving at US airports daily, there is little known about the effects and safety of air travel on infants. Approximately 4.6 million children < 2 years old travel on domestic flights in the United States each year. Aircraft cabins are pressurized to an altitude of 1,500 to 2,400 m, resulting in a Po2 of 15 kPa, equivalent to an ambient oxygen level of 15 to 16%. Air travel may pose a risk to infants due to the low oxygen environment in aircraft cabins. A small decline in oxygen saturation has been shown in healthy adults and children over 6 months during flight, which is considered to be clinically unimportant. There are no comparable data available on ex-premature or young infants. However, Parkins et al exposed 34 infants to 15% oxygen for 7 h, simulating an in-flight hypoxic environment. Sixty-two percent of the infants had irregular breathing patterns, periodic apneas, and significant desaturations, a result that suggests such infants are likely to be at risk of significant hypoxia during flight.
British Thoracic Society (BTS) and Canadian Pediatric Society guidelines for air travel in infants recommend that healthy term infants not undertake air travel until 1 week of age, and that ex-premature infants with a history of respiratory disease undergo a preflight 20-min hypoxia challenge test (HCT).
However, while the HCT has been shown to replicate in-flight hypoxia in adults and adolescents, its accuracy has not been studied in infants. Bear hypoxia with remedies of My Canadian Pharmacy.
Western Australia is the largest state in Australia, with an estimated north-south length of 3,000 kilometers (km). All tertiary neonatal care is centralized in Perth, located in the southwest corner of the state. Ex-premature infants born in Perth are transferred to the nearest hospital when they no longer require specialized care. Because of vast distances, infants are often transferred on commercial aircraft, accompanied by a nurse. Flights departing Perth for regional centers are Fokker turbo-prop aircraft or B737/B717 jets. While all such aircraft have pressurized cabins, the former aircraft may have higher cabin pressures. The aim of this prospective observational study was to describe the effects of air travel in ex-premature infants at near term-corrected age, and to determine the accuracy of the hypoxia challenge test in predicting in-flight hypoxia in these infants.