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

• Published in: Sleep & breathing Vol. 26; no. 2; pp. 887 - 891
• Main Authors: Chiang, Jackie, Varadi, Robert, Snow, Nadia, Al-Saleh, Suhail, Mehta, Kevan, Al-Awadi, Aceel, Almajeed, Athari, McAdam, Laura, Goldstein, Roger, Amin, Reshma
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2022; Springer Nature B.V
• Subjects: Adolescent; Air Travel; Carbon dioxide; Cross-Sectional Studies; Dentistry; Female; Heart; Humans; Hypercapnia; Hypoxia; Hypoxia - diagnosis; Hypoxia - etiology; Internal Medicine; Male; Medicine; Medicine & Public Health; Neurology; Neuromuscular diseases; Neuromuscular Diseases - complications; Neuromuscular Diseases - diagnosis; Ostomy; Otorhinolaryngology; Oxygen; Oxygen therapy; Patients; Pediatrics; Pediatrics • Short Communication; Pneumology/Respiratory System; Respiratory diseases; Stroke Volume; Tracheostomy; Travel; Ventricle; Ventricular Function, Left; Neuromuscular disease; Air travel; Hypoxic challenge test; Non-invasive ventilation
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-021-02462-5

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 One patient was withdrawn because he was unable to follow the study procedures.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 Two participants were withdrawn on the day of testing due to hypercapnia.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.