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Air travel can rob the body of oxygen

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Lisa Salberg Find out more about Lisa Salberg
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  • Air travel can rob the body of oxygen

    Air travel can rob the body of oxygen   

    May 05 (Reuters Health) - If flying makes you breathless, there may be good reason. New research suggests that air travel can diminish the blood's oxygen supply to levels that, on the ground, might require treatment.


    The study of 84 airline passengers found that when flights were at maximum altitude, more than half of the passengers had "oxygen saturation" levels at or below 94 percent. This means that less than 95 percent of their red blood cells were fully loaded with oxygen, a level at which many doctors would give a person supplemental oxygen, according to the study authors.


    All of the passengers, whether on short or long flights, showed declines in their blood oxygen levels, with the average oxygen saturation descending from 97 percent on the ground to 93 percent at cruising altitude, the authors report in the journal Anaesthesia.


    The main concern with such oxygen dips is how they could affect passengers with heart or lung disease, said study co-author Dr. Rachel Deyermond of Ulster Hospital in Belfast, Northern Ireland.


    For someone with lung disease, a loss of a few percentage points in oxygen saturation could trigger shortness of breath, Deyermond told Reuters Health. A person with heart disease, she said, may suffer chest pain, or have an increased risk of a heart attack or irregular heart rhythm.


    It's also possible that significant drops in oxygen levels could contribute to deep vein thrombosis (DVT) -- blood clots in the legs that some passengers develop during long-haul flights.


    Besides the effects it can have on the chronically ill, oxygen deprivation can create some less serious problems during and after a flight, including physical and mental fatigue, headache and digestive problems.


    According to Deyermond, in-flight symptoms such as breathlessness, chest pain or confusion may signal that a person has dropping oxygen levels. In such cases, passengers with heart or lung disease can ask the crew for oxygen, she said. Healthy people may need only to drink some water, as dehydration compounds the effects of oxygen loss.


    Avoiding alcohol and sleeping pills, Deyermond added, may also help.


    She suggested that before taking a flight, people with heart or lung disease have their doctors measure their oxygen saturation. If it is already low, she explained, then patients will know it could drop to problematic levels, and they could tell the airline they will need oxygen during the flight.


    SOURCE: Anaesthesia, May 2005.
    Publish Date: May 05, 2005
    Knowledge is power ... Stay informed!
    YOU can make a difference - all you have to do is try!

    Dx age 12 current age 46 and counting!
    lost: 5 family members to HCM (SCD, Stroke, CHF)
    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
    Therapy - ICD (implanted 97, 01, 04 and 11, medication
    Currently not obstructed
    Complications - unnecessary pacemaker and stroke (unrelated to each other)

  • #2
    Lisa
    Those are very scary stats! I'm planning a flight to Fla, on Thurs (2 1/2 Hour flight) and a flight to London, in July.
    Do I alert the flight attendant upon boarding, that I may need oxygen/wait till I sense a problem & request the oxygen? I suffer from SOB, from time to time, but have not previously identified this problem while flying. I'll definitely be more alert, in the future & share this info with my Husband (my fligt partner)
    Thanks for the info
    RONNIE

    Comment


    • #3
      This is very interesting. I am not aware of being short of oxygen when flying, although I do have some chest and arm pain sometimes when there is a quick change in altitude. I

      I was most interested in the statement that many doctors give supplemental oxygen at 94%. I have noticed that my oxygen levels are most commonly around 94-95 on the occasions when they have been measured. However, of course, they do not typically get measured when I am feeling well. This also explains why the doc here in Beijing did not want me to fly home last time when I had pneumonia. At that time my O2 saturation was around 93-94. I thought that anything above 90 was pretty much OK, so I was surprised that he seemed alarmed when it was at 93.

      Rhoda

      Comment


      • #4
        "Hypobaric hypoxia (hypoxia due to a lowered oxygen pressure at altitude) is a major concern for airline travelers with cardiovascular disease. At a cabin altitude of 8000 ft, the inspired partial pressure of oxygen is 108 mm Hg (versus 149 mm Hg at sea level). This correlates with a PaO2 (arterial O2 pressure) of 50-60 mm Hg in people with normal baseline PaO2. If these last data are plotted on the oxyhemoglobin dissociation curve, we obtain a blood oxygen saturation of 90%.

        Although most healthy travelers can normally compensate for this amount of hypoxemia, this may not be true for coronary, pulmonary, cerebrovascular, and anemic patients. Because these patients may already have a reduced PaO2 on the ground, further reduction in aircraft cabin pressure will bring them to the steep part of the oxyhemoglobin dissociation curve with a resultant very low saturation, which could cause distress and/or exacerbation of their illness.

        Cardiac patients compensate to some extent for inflight hypoxia by increasing minute ventilation, mainly by increasing tidal volume. The primary cardiac response to hypoxia is mild tachycardia, which results in increased myocardial oxygen demand. In patients with limited cardiac reserve, the decreased oxygen supply at altitude and resultant tachycardia may result in symptoms and cardiac decompensation. Consequently, in some cases, medical oxygen may be required.

        The managing physician must be mindful that the excitement and stress of air travel can further precipitate symptoms in individuals with limited reserve.

        Severe decompensated congestive heart failure (CHF) is a contraindication to air travel. However, in stable CHF, inflight medical oxygen is advisable for patients with New York Heart Association (NYHA) class III-IV CHF or baseline PaO2 less than 70 mm Hg."

        Medical Guidelines for Airline Travel, 2nd Edition
        Aerospace Medical Association
        Medical Guidelines Task Force
        Alexandria, VA
        "Some days you're the dog... some days you're the hydrant."

        Comment


        • #5
          The term cabin altitude refers to the ground elevation equivalent that is being supplied by the airline's cabin pressurization. Given an average cabin altitude of 6000 to 8000 ft across the board, on a typical domestic flight you are receiving between 20 and 25% less oxygen than if you were standing at or near sea level.

          It is interesting to note that commercial airlines are permitted to breach the 8000 ft cabin altitude mark short-term, for instance if the pilot makes a hasty maneuver to avoid a storm, turbulence, etc. One study i came upon noted cabin altitudes on several commercial airlines in excess of 9000 ft. As a footnote here, oxygen masks are deployed at a cabin altitude of 12,000 ft.

          Since even healthy, normal-hearted people can experience symptoms of altitude sickness due to decreased oxygen levels, one would have to assume that for those HCM'ers who normally experience shortness of breath anyway, symptoms would be exacerbated.

          In Denver, for instance, which is at an elevation of approximately 5,280 feet, there is 17% less oxygen in the air than at sea level. At 8000 feet the amount of available oxygen is 25% less than at sea level. About 25% of unacclimated people develop symptoms of altitude sickness at only 6000 feet. Symptoms include headache, fatigue, shortness of breath, and nausea. It takes 1 to 2 days for the average person to fully acclimatize to altitudes of up to 10,000 feet. More time is required for altitudes above that.

          Regarding air travel... by law, the cabin pressure of a commercial airline cannot be less, at maximum cruise altitude, than the equivalent of outside air pressure at 8,000 feet. That's still pretty thin air. Therefore, symptoms of altitude sickness can, and do occur during air travel. An air traveler also has no chance to acclimate... the ascent from sea level to 8000 feet (effectively) can take place in a matter of minutes. This could certainly explain why some HCM'ers experience increased symptoms in-flight.

          I have references to this material available on request.

          Jim
          "Some days you're the dog... some days you're the hydrant."

          Comment


          • #6
            I am flying in june to oregon. I see my doctor before I go. I have never been on a plane. Good to know.

            Angela

            Comment


            • #7
              As you guys know I do fly several times per year. I notice once I hit about 25K feet that my breathing is difficult. It balances off after a little while, lately I have have a very had time staying awake on a plane - I am wondering if this is an O2 issue?

              Just some thoughts,
              Lisa
              Knowledge is power ... Stay informed!
              YOU can make a difference - all you have to do is try!

              Dx age 12 current age 46 and counting!
              lost: 5 family members to HCM (SCD, Stroke, CHF)
              Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
              Therapy - ICD (implanted 97, 01, 04 and 11, medication
              Currently not obstructed
              Complications - unnecessary pacemaker and stroke (unrelated to each other)

              Comment


              • #8
                Oh, great. One more thing to worry about.

                I haven't had any sort of trouble with air travel. If it's a long flight (more than 2 hours) I usually develop a headache mid-flight or shortly after arrival, but that has more to do with my sinuses than anything.
                Life is a banquet...and I got botulism! -- Me

                If time flies when you're having fun, will I age faster at Disneyland? -- Joel Perry

                Comment


                • #9
                  Simple options

                  Hi!

                  It is important to move the legs, roll the uncles, drink water, and do some streching to help the blood circulation and try to prevent the headache....
                  especially after sleeping during the flight. Also try not to watch the window and not read, It is better to listen to music.
                  Wishes for healh, peace and love!

                  Daniela E-H, Mother to Matan-Ben (13 years old) who had his AICD implantation (29/03/04) and Myectomy (14/12/08) and Noga (4 years old) not affected
                  Haifa - Israel.

                  Comment


                  • #10
                    I've just gotten the courage to fly to Hawaii next month and now I read this! That's all I need for that LONG flight...to go into AFIB up there! And I am going on 15 weeks without an AFIB episode...I have a call into my cardiologist in Boston anyway about getting copies of records to take with me just in case. I also left a message asking for a referral and something to relax me when I get on the plane!! I think my normal oxygen sat is 98%...it was 99% when it was taken before my colonoscopy...now I have this to worry about
                    \"It is not length of life, but depth of life.\"

                    Ralph Waldo Emerson

                    Comment


                    • #11
                      At the meeting one of the doctors mentioned that Airports are the # 1 place for heart attacks. I just wonder if this relates. Could it be that it’s after they get off the plane that most of those attacks happen?

                      Just food for thought.

                      Stuart
                      Cleveland Myectomy Club
                      August 31, 2004

                      Comment


                      • #12
                        Cynthia,

                        If it is any encouragement, I do not ever recall having an oxygen sat of 98 or 99%. Mine is good when it is 96-97. But I fly to China and back twice a year and have been fine so far. As I have said before, I get a little chest pain from time to time and have lots of fluid retention problems, but so far, nothing that seems to be a big problem.

                        Rhoda

                        Comment

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