Hypoxia Challenge Testing in Neonates for Fitness to Fly

Vetter-Laracy, Susanne; Osona, Borja; Peña-Zarza, Jose Antonio; Gil, José A.; Figuerola, Joan

doi:10.1542/peds.2015-2915

Cited by 12 publications

(3 citation statements)

References 25 publications

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“…Other similar approaches have been advocated in which oxygen was discontinued for up to 30 minutes to document that a nadir SpO 2 value does not fall below 80% [ 31 ]. A hypoxia challenge test has been described using subnormal (0.15 FiO2) oxygen and a body plethysmograph but the clinical utility of such a test is impractical in the NICU [ 47 ]. Another approach was using modified polysomnography to determine “stable versus unstable” infants but this study with 30 subjects does not provide enough evidence for its regular use [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease

Hussain

Schwenn

Trzaski

et al. 2018

International Journal of Pediatrics

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Background In infants with CLD there are no objective tests to monitor an infant's progress towards weaning out of oxygen inhalation therapy (O2IT). A test involving staged maneuvers of increasing respiratory stress while decreasing oxygen support, termed Stress Oximetry (StressOx), has been used at our center for weaning O2IT. Objective To report the clinical utility of “StressOx” in evaluating readiness for discontinuing O2IT in infants with CLD. Methods A retrospective review was done of StressOx tests administered at our center from 2002-2008. StressOx was performed based on a consistent clinical protocol in all eligible infants on O2IT. O2IT was generally discontinued after infant had passed two StressOx tests and subsequently infants were monitored for a minimum of 7 days to determine successful weaning. Results There were 279 infants with 899 tests that met inclusion criteria. An average of 3 tests per infant was done, one week apart. The test had a specificity of 97.4% and a positive predictive value of 99.6% in determining success of discontinuing O2IT. Conclusions StressOx appears to be a clinically useful test that may help in determining an infant's ability to successfully wean out of O2IT. Further validation of this test is warranted.

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Section: Discussionmentioning

confidence: 99%

Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease

Hussain

Schwenn

Trzaski

et al. 2018

International Journal of Pediatrics

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“…A seated subject is placed in a whole body plethysmograph and given a mixture of 15% oxygen in nitrogen. In older children, a non-rebreathing mask can be used instead, although this is considered less reliable due to insufficient sealing of the mask [ 10 , 11 ]. Supplemental oxygen during flight should be recommended if peripheral oxygen saturation (SpO 2 ) falls < 85 or < 90% depending on age (< 1 or ≥ 1 year of age respectively) [ 9 ].…”

Section: Medical Assessment Of Fitness To Fly In Childrenmentioning

confidence: 99%

“…Desaturation (SpO 2 < 85%) during HAST is rare in term neonates during the first week of life but more common in preterm neonates, especially when diagnosed with bronchopulmonary dysplasia (BPD). In the latter, around 70% of neonates desaturate during HAST [ 11 , 14 , 18 ]. The recommendations of the BTS are to refrain from air travel for 1 week after birth in term children.…”

Section: Hypoxiamentioning

confidence: 99%

Fitness to fly in the paediatric population, how to assess and advice

et al. 2018

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The number of children on commercial aircrafts is rising steeply and poses a need for their treating physicians to be aware of the physiologic effects and risks of air travel. The most important risk factors while flying are a decrease in partial oxygen pressure, expansion of trapped air volume, low cabin humidity, immobility, recirculation of air and limited options for medical emergencies. Because on-board medical emergencies mostly concern exacerbations of chronic disease, the medical history, stability of current disease and previous flight experience should be assessed before flight. If necessary, hypoxia altitude simulation testing can be performed to simulate the effects of in-flight hypoxia. Although the literature on paediatric safety of air travel is sparse, recommendations for many different situations can be given.Conclusion: We present an overview of the most up to date recommendations to ensure the safety of children during flight. What is Known: • Around 65% of on-board medical emergencies are complications of underlying disease.• In children, the three most common emergencies during flight concern respiratory, neurological and infectious disease. What is New: • Although studies are scarce, some advices to ensure safe air travel can be given for most underlying medical conditions in children, based on physiology, studies in adults and expert opinions.• In former preterm infants without chronic lung disease, hypoxia altitude simulation testing to rule out in-flight desaturation is not recommended.Electronic supplementary materialThe online version of this article (10.1007/s00431-018-3119-9) contains supplementary material, which is available to authorized users.

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Kinder auf Reisen

Kerbl

2018

Monatsschr Kinderheilkd

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Hypoxia Challenge Testing in Neonates for Fitness to Fly

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.

Cited by 12 publications

References 25 publications

Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease

Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease

Fitness to fly in the paediatric population, how to assess and advice

Kinder auf Reisen

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