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Hypoxic challenge test applied to healthy children

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Authors:
  • Kobbernagel, Helene Elgaard ;
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    Aarhus University
  • Nielsen, Kim Gjerum ;
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    Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark
  • Hanel, Birgitte
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    Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark
Subtitle:
influence of body positions and exertion on pulse oximetric saturation
DOI:
10.1136/archdischild-2012-302763
Abstract:
BACKGROUND: Commercial aircraft are pressurised to ~2438 m (8000 ft) above sea level that equates breathing 15% oxygen at sea level. A preflight hypoxic challenge test (HCT) is therefore recommended for children with cystic fibrosis or other chronic lung diseases and inflight oxygen is advised if pulse oximetric saturation (SpO2) decreases <90%. OBJECTIVE: Study responses to a modified HCT, encompassing various body positions and light physical activity, reflecting relevant activities of children during flight, with a view to challenge the evidence of the current cut-off. METHODS: Oxygenation, heart rate and ventilation were observed in 34 healthy schoolchildren (17 boys) undergoing a modified HCT, alternating between breathing room air and 15% oxygen in nitrogen while seated, supine, standing and walking at 3 km/h and 5 km/h. RESULTS: Nadir SpO2 <90%, median (range), occurred in 9 subjects sitting, 89% (78-89%); 6 supine, 88.5% (87-89%); 9 standing, 89% (85-89%); 23 walking 3 km/h, 87% (74-89%); and 21 walking 5 km/h, 86% (74-89%). Total time <90% for these subjects in seconds was 20 (10-80) sitting, 30 (10-190) supine, 50 (10-150) standing, 80 (10-260) walking 3 km/h and 125 (10-300) walking 5 km/h. Light exercise in general led to lower SpO2: 91% (77-96%), p<0.0001. CONCLUSIONS: A modified HCT led to moments of desaturation below 90% in various body positions at rest and during light physical activity in healthy schoolchildren. It is questionable whether the international recommended cut-off of 90% for children with chronic lung disease reflects clinical oxygen dependence during flights.
Type:
Journal article
Language:
English
Published in:
Archives of Disease in Childhood, 2013, Vol 98, Issue 8, p. 602-6
Keywords:
Adolescent; Air Ambulances; Altitude; Child; Chronic Disease; Cross-Over Studies; Cross-Sectional Studies; Exercise; Female; Humans; Lung Diseases; Male; Oximetry; Oxygen; Posture; Prospective Studies; Questionnaires; Spirometry; Journal Article; Research Support, Non-U.S. Gov't
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2013
Scientific Level:
Scientific
ID:
243466363

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