Recommendations of Edvardsen et al for Pre-Flight Evaluation of a Patient with Cystic Fibrosis (CF)

Patient selection: patient with cystic fibrosis

Pre-flight evaluation: high-altitude simulation test (HAST) by breathing 15.1% oxygen during exercise testing on a treadmill. 15.1% oxygen corresponds to an airplane flight at 2,434 meters. PaO2 was monitored with an intra-arterial catheter. The PaO2 during HAST tended to decline as the FEV1 as percent of predicted declined.

Supplemental oxygen is recommended if the PaO2 falls below 6.6 kPa (45.1 mm Hg) during the test. A stable pre-flight PaO2 > 9.3 kPa (70 mm Hg) does not exclude hypoxemia during a flight.

The percutaneous oxygen saturation (SpO2) during HAST is an inferior measure of hypoxemia during flight.

Additional risk factors for cystic fibrosis patients:

(1) deep vein thrombosis with venous thromboembolism

(2) transmission of organisms capable of causing respiratory infection

(3) active pneumonia