Indirect Measurements of Acceleration Atelectasis and the Role of Inspired Oxygen Concentrations

BACKGROUND: A growing number of symptom reports suggestive of acceleration atelectasis in fast jet aircrew have raised the question as to whether traditional guidelines on inspired gas composition remain valid. The aim of this study was to assess the effects of inspired O₂ concentration on the development of acceleration atelectasis when wearing modern anti-G garments. METHODS: There were 14 nonaircrew subjects who completed 5 centrifuge exposures to +5 G_z lasting 90 s. During exposures subjects breathed a gas mixture containing 21, 35, 45, 60, or 75% O₂. To assess the extent of atelectasis post-G_z, forced inspiratory vital capacity (FIVC), regional FIVC (EIT_FIVC), shunt, respiratory resistance, reactance, and compliance and peripheral O₂ saturation during a hypoxic exposure were measured. RESULTS: Compared with baseline, FIVC was not statistically significantly altered. EIT_FIVC was 14.4% lower after the 75% O₂ exposure only with a greater symptom reporting with higher F_IO₂ in some individuals. A significantly greater shunt (3>6%) followed the 60 and 75% O₂ exposures. O₂ concentration during G_z had no effect on respiratory resistance, reactance, compliance, or hypoxemia. DISCUSSION: There is evidence of mild acceleration atelectasis present when breathing 60% O₂, particularly in susceptible individuals, with 75% O₂ causing more obvious physiological compromise. An inspired oxygen concentration of <60% will prevent the majority of individuals from developing acceleration atelectasis. Pollock RD, Gates SD, Radcliffe JJ, Stevenson AT. .