Hypoxic Challenge Testing (Fitness to Fly) in children with complex congenital heart disease

Autor: Rodney C. G. Franklin, Nitha Naqvi, Victoria L Doughty, Ian M. Balfour-Lynn, Simon Ward, Piers E.F. Daubeney, Luke Starling
Rok vydání: 2018
Předmět:
Heart Defects
Congenital
Male
medicine.medical_specialty
Adolescent
Aircraft
Supplemental oxygen
030204 cardiovascular system & hematology
airplane
1102 Cardiovascular Medicine And Haematology
Risk Assessment
QT interval
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Fraction of inspired oxygen
Heart rate
medicine
Humans
030212 general & internal medicine
Complex congenital heart disease
Child
Hypoxia
business.industry
airflight
Altitude
Age Factors
Hemodynamics
Infant
Mean age
Carbon Dioxide
congenital heart disease
Oxygen
Air Travel
Cardiovascular System & Hematology
Child
Preschool
Aerospace Medicine
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Challenge testing
Blood Gas Monitoring
Transcutaneous
Biomarkers
Zdroj: Heart. 104:1333-1338
ISSN: 1468-201X
1355-6037
Popis: ObjectiveCommercial airplanes fly with an equivalent cabin fraction of inspired oxygen of 0.15, leading to reduced oxygen saturation (SpO2) in passengers. How this affects children with complex congenital heart disease (CHD) is unknown. We conducted Hypoxic Challenge Testing (HCT) to assess need for inflight supplemental oxygen.MethodsChildren aged 2 (≥95% vs 2, heart rate, QT interval corrected for heart rate and partial pressure of carbon dioxide measured transcutaneously (PtcCO2). A test failed when children with (1) normal baseline SpO2 desaturated to 85%, (2) baseline SpO285%–94% desaturated by 15% of baseline; and (3) baseline SpO275%–84% desaturated to 70%.ResultsThere were 68 children, mean age 3.3 years (range 10 weeks–14.5 years). Children with normal (n=36) baseline SpO2 desaturated from median 99% to 91%, P2 (n=32) desaturated from median 84% to 76%, P2, heart rate and QT interval corrected for heart rate were unaffected by the hypoxic state.ConclusionsThis is the first evidence to help guide which children with CHD need a preflight HCT. We suggest all children with an actual or potential R–L shunt should be tested.
Databáze: OpenAIRE
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