26.06.2024
Chronic Obstructive Pulmonary Disease (COPD) is a significant health
concern that used to be considered untreatable, but enhancing
patients' well-being and improving their quality of life is now made
possible thanks to recent advancements. Be it the personalized medical
treatments patients receive based on their individual needs or the
effective exacerbation management and support for physical activity
and rehabilitation, there are now many ways to help COPD patients.
Other than these, accessible treatments like long-term oxygen therapy
and noninvasive ventilation are empowering COPD patients to have a
more active lifestyle, which brings us to today’s topic: Air travel
with COPD.
No need to mention that commercial air travel is a preferred and
common mode of transportation for billions of passengers all around
the world each year. Taking the aging population into account, this
means more and more travelers with pre-existing conditions like COPD.
In this context, it should be one of the missions of healthcare
providers and patients to assess and minimize the potential risks that
are associated with air travel in order to ensure the safety and
health of COPD patients. Of course, there are ways to enable a
comfortable flight where you can sit back and relax, which we will be
going over in this very article as well.
So what are the potential situations that may occur? First off, since
aircraft cabins are pressurized to 8000 feet above sea level, the
oxygen levels in the aircraft are reduced. For individuals that do not
have COPD, the risk of experiencing hypoxia is low, but the same
cannot be said for COPD patients. The primary difference between cabin
and ground environments is atmospheric pressure, resulting in
hypobaric hypoxia for not just individuals with COPD, but all
passengers. COPD patients are at higher risk due to the fact that
hyperventilation and hyperinflation are known to worsen hypoxia,
especially during minor activity.
Subtle hypoxia symptoms, such as cognitive impairment are a potential
risk that can be experienced by a COPD patient during air travel.
Unfortunately, medical emergencies during flights are relatively
common, occurring in approximately one out of every 604 flights, with
respiratory illnesses accounting for a significant proportion of these
cases. One should also mention that diversion due to medical issues
can be costly as well. Therefore, it is suggested to do a pre-flight
screening for at-risk passengers for the sake of reducing such
inconvenient events.
Acute hypoxia triggers sympathetic activation, resulting in increased
heart rate, blood pressure, and cardiac output. This results in severe
complications during the flight, including cardiac arrhythmias and
chest pain for patients who cannot respond adequately to these
physiological changes. Other than hypoxia, COPD patients may
experience common symptoms of COPD during air travel, like shortness
of breath and chest pain, often exacerbated by cabin conditions of low
humidity and recirculated air. Additionally, sleep is common during
long-haul flights, and it can cause significant drops in oxygen
saturation, particularly in COPD patients.
Although assessing COPD patients for in-flight hypoxemia is a complex
process, and there is no consensus on the gold standard assessment
method, pulmonary function tests, such as spirometry, can provide
valuable information. But again, even their ability to predict
in-flight hypoxemia is limited. Walk tests, for instance the 6-minute
walk test, can assess functional capacity and exercise-induced
hypoxemia.
“So, are you indicating that COPD patients should not fly?” Of course,
that is not the case. There are ways to prepare COPD patients for air
travel and optimize their treatment. Assessing their risk of in-flight
hypoxemia is one point to start. Involving general practitioners in
the process, ensuring an adequate supply of medications, and having
proper health insurance are key to planning your flight. Other than
that, supplemental oxygen is crucial for many patients to prevent
acute hypoxia and the choice of delivery method depends on their
clinical status. COPD patients and their caregivers must also consider
additional factors like jet lag, sleep disturbances, and the risk of
thromboembolism, and be cautious about respiratory infections.
In conclusion, traveling with COPD may be a risk to take, but not
something to be afraid of when carefully planning and considering the
unique challenges of that certain flight are thoroughly done. Many
patients can safely fly, assuming that their specific needs are
addressed. Disease management done with proactive strategies during
air travel is essential for ensuring COPD patients’ well-being: Both
on the ground and in the air. In this process, healthcare providers,
patients, and airlines all play non-interchangeable vital roles, each
in their own way.
To help you in your pre- journey planning, we recommend you use our
Breathment App where you can perform exercises from home that are
assigned to you based on your individual needs and proven to improve
your quality of life. Book an appointment now to explore how
Breathment helps you ease your symptoms easily.
