Hypoxia Challenge Testing in Neonates for Fitness to Fly

Pediatrics. 2016 Mar;137(3):e20152915. doi: 10.1542/peds.2015-2915. Epub 2016 Feb 15.

Abstract

Background: Preflight hypoxia challenge testing (HCT) in a body plethysmograph has previously been done only on infants >3 months of corrected gestational age (CGA). This study aims to determine the earliest fit-to-fly age by testing neonates <1 week old.

Methods: A prospective observational study was carried out on 3 groups of infants: healthy term infants ≤7 days old, preterm infants (≥34 weeks CGA) 2 to 3 days before discharge, and preterm infants with bronchopulmonary dysplasia (BPD). HCT was conducted using a body plethysmograph with a 15% fraction of inspired oxygen. The oxygen saturation (Spo2) test fail point was <85%.

Results: Twenty-four term (mean CGA 40 weeks), 62 preterm (37 weeks), and 23 preterm with BPD (39.5 weeks) infants were tested. One term infant (4.2%) and 12 preterm infants without BPD (19.4%) failed. Sixteen (69.3%) preterm infants with BPD failed (P < .001), with a median drop in Spo2 of 16%. At 39 weeks CGA, neither preterm infants without BPD nor term infants had an Spo2 <85%. However, 7 of 12 term infants with BPD failed the HCT.

Conclusions: Term and preterm infants without BPD born at >39 weeks CGA do not appear to be likely to desaturate during a preflight HCT and so can be deemed fit to fly according to current British Thoracic Society Guidelines.

Publication types

  • Observational Study

MeSH terms

  • Aerospace Medicine / methods*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Hypoxia / diagnosis*
  • Hypoxia / metabolism
  • Infant Nutritional Physiological Phenomena / physiology*
  • Infant, Newborn
  • Infant, Premature / blood*
  • Infant, Premature, Diseases / diagnosis*
  • Infant, Premature, Diseases / metabolism
  • Male
  • Oxygen / blood
  • Plethysmography / methods
  • Prospective Studies
  • Travel*

Substances

  • Oxygen