Some of our patients travel this time of the year to escape the cold and inclement weather. Those with significant lung problems, especially those that use oxygen, often have concerns about air travel. At times physicians are asked to supply a written statement to the airlines about the patient’s travel worthiness.
No patient, whether with pulmonary disease or any other, should consider air travel in an unstable or evolving disease condition. In addition, no patient should travel if they have a condition which puts other airline passengers at risk. No patient, without medical assessment, should travel within 6 weeks of a hospital discharge for an acute respiratory illness, severe COPD, recent pneumothorax, and risk or history of previous pulmonary embolism. Absolute contraindications to air travel include infectious tuberculosis, pneumothorax with persistent air leak, persistent coughing of blood, and the need for supplemental oxygen requiring flow rates above 4 liters/minute at sea level.
Altitude exposure may worsen a low baseline oxygen level in patients with pulmonary disease. Commercial airlines pressurize their cabins up to 8,000 feet but could go higher in emergencies. The oxygen concentration in the cabin falls from 21% to 15% at these altitudes. This will lower the resting blood oxygen level to 60 – 75 mmHg (Normal = 80-100) increasing the need for supplemental oxygen, or increases in supplemental oxygen in patients with baseline hypoxia.
Advanced planning is needed for airline travel if you have severe lung disease. Ask your physician for suggestions and advice.