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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Pre-flight testing of preterm infants with neonatal lung disease: a retrospective review
K Udomittipong1, S M Stick, M Verheggen
1Clinical Sciences, Telethon Institute for Child Health Research and Centre for Child Health Research, University of Western Australia, Perth, Australia.
Insights
Infants with respiratory issues flying may need supplemental oxygen. A hypoxia test can predict this need, especially for those under 12 months corrected age.
Area of Science:
- Pediatric Pulmonology
- Aerospace Medicine
- Neonatology
Background:
- Air travel poses hypoxia risk for respiratory patients.
- Limited data exists on oxygen needs for infants with respiratory disease during flights.
- A study assessed factors predicting in-flight oxygen needs in infants.
Purpose of the Study:
- Identify clinical factors predicting in-flight oxygen requirements in infants.
- Evaluate the utility of hypoxia challenge tests for fitness-to-fly assessments in infants.
- Determine oxygen needs for infants with respiratory disease planning air travel.
Main Methods:
- Retrospective review of hypoxia challenge tests in 47 infants.
- Analyzed neonatal and current clinical data to predict hypoxia test outcomes.
- Hypoxia test involved 20 minutes of 14-15% oxygen inhalation.
Main Results:
- 81% of infants desaturated below 85%, requiring supplemental oxygen.
- Age at hypoxia testing significantly predicted the need for in-flight oxygen.
- Infants needing oxygen were significantly younger (median corrected age 0 months) than those who passed.
Conclusions:
- Ex-preterm infants under 12 months corrected age risk requiring in-flight oxygen.
- Fitness-to-fly assessment including hypoxia testing is indicated for this group.
- Early identification of oxygen needs is crucial for infant air travel safety.
Background:
The low oxygen environment during air travel may result in hypoxia in patients with respiratory disease. However, little information exists on the oxygen requirements of infants with respiratory disease planning to fly. A study was undertaken to identify the clinical factors predictive of an in-flight oxygen requirement from a retrospective review of hypoxia challenge tests (inhalation of 14-15% oxygen for 20 minutes) in infants referred for fitness to fly assessment.
Methods:
Data from 47 infants (median corrected age 1.4 months) with a history of neonatal lung disease but not receiving supplemental oxygen at the time of hypoxia testing are reported. The neonatal and current clinical information of the infants were analysed in terms of their ability to predict the hypoxia test results.
Results:
Thirty eight infants (81%) desaturated below 85% and warranted prescription of supplemental in-flight oxygen. Baseline oxygen saturation was >95% in all infants. Age at the time of the hypoxia test, either postmenstrual or corrected, significantly predicted the outcome of the hypoxia test (odds ratio 0.82; 95% confidence intervals 0.62 to 0.95; p = 0.005). Children passing the hypoxia test were significantly older than those requiring in-flight oxygen (median corrected age (10-90th centiles) 12.7 (3.0-43.4) v 0 (-0.9-10.9) months; p < 0.0001).
Conclusions:
A high proportion of ex-preterm infants not currently requiring supplemental oxygen referred for fitness-to-fly assessment and less than 12 months corrected age are at a high risk of requiring in-flight oxygen. Referral of this patient group for fitness to fly assessment including a hypoxia test may be indicated.
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