Pre-Flight Hypoxemia Challenge Testing in Bronchopulmonary Dysplasia

Area of Science:

• Pediatric Pulmonology
• Neonatal Medicine
• Aerospace Medicine

Background:

• Infants with bronchopulmonary dysplasia (BPD) face risks of hypoxemia during air travel.
• The age at which these risks diminish is not well-established.

Purpose of the Study:

• To determine pass rates for high altitude simulation testing (HAST) by age in children with BPD.
• To identify risk factors associated with failing HAST.

Main Methods:

• Retrospective analysis of 94 HAST studies in 63 children with BPD.
• Interval censoring was used to estimate time-to-event curves for passing HAST.
• Pass criteria included Spo2 ≥ 90% or ≥94% for those with pulmonary hypertension (PH).

Main Results:

• Overall, 63% of HAST studies were passed.
• At 24 months corrected gestational age (CGA), 85% of subjects passed HAST.
• Factors associated with delayed passing included postnatal corticosteroid use, NICU discharge with respiratory support, and tracheostomy.

Conclusions:

• Children with BPD on respiratory support at 36 weeks require HAST consideration up to at least 24 months CGA.
• Extended HAST evaluation is recommended for those with a history of PH or discharged from NICU on respiratory support.