Assessing air travel safety in neuromuscular disease: standard versus prolonged hypoxic challenge tests

Sleep Breath. 2022 Jun;26(2):887-891. doi: 10.1007/s11325-021-02462-5. Epub 2021 Aug 7.

Abstract

Purpose: The hypoxic challenge test (HCT) is used to evaluate safety for air travel in individuals with respiratory disease by breathing in 15% oxygen for 20 min. Our aim was to determine if a prolonged HCT, lasting 120 min, identified more individuals with neuromuscular disease at potential risk than the standard HCT lasting 20 min.

Methods: This was a cross-sectional study. All of the clinical testing took place at SickKids, Toronto, Canada. Patients were included in the study if they had a diagnosis of NMD, greater than 6 years of age, resting oxygen saturation ≥ 94%, and partial pressure of carbon dioxide (pCO2) ≤ 45 mmHg. Notable exclusion criteria were left ventricular ejection fraction < 30%, presence of a tracheostomy, and use of non-invasive ventilation for more than 12 h daily. Participants underwent a standard HCT as well as the prolonged HCT on the same day.

Results: Twenty-three patients consented to the study. One patient was withdrawn because he was unable to follow the study procedures. The 22 study participants had a mean age of 14.9 years (standard deviation (SD) of 5 years). Seventeen (77%) participants were male. Two participants were withdrawn on the day of testing due to hypercapnia. Twenty participants completed the standard and prolonged HCTs. None of the participants had a positive standard or prolonged HCT.

Conclusion: Our results suggest that performing a standard or prolonged HCT may, in fact, not be of clinical utility in individuals with less severe NMD.

Keywords: Air travel; Hypoxic challenge test; Neuromuscular disease; Non-invasive ventilation.

MeSH terms

  • Adolescent
  • Air Travel*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypoxia / diagnosis
  • Hypoxia / etiology
  • Male
  • Neuromuscular Diseases* / complications
  • Neuromuscular Diseases* / diagnosis
  • Stroke Volume
  • Ventricular Function, Left