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      Are pulmonologists well aware of planning safe air travel for patients with COPD? The SAFCOP study

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          Patients with respiratory diseases are more prone to health risks of air travel.


          The aim of this study was to investigate the current knowledge and attitudes of Turkish pulmonary physicians for air travel in patients with chronic obstructive pulmonary disease (COPD).

          Participants and methods

          A questionnaire was developed and administered either by congress mobile phone application or by e-mail. A total of 242 physicians participated in the study (75 by mobile phone application and 167 through the e-mail).


          Among participants, only 30.6% reported that they usually inform COPD patients about possible risks of air travel in their routine practice. A preflight assessment was performed by 61.2% of them and a fit to fly report was prepared by 34.3%. The most common methods/tests used for preflight assessment were reported as oxygen saturation with pulse oximetry, arterial blood gas analysis, and pulmonary function tests (51.2%, 50.8%, and 49.6%, respectively). When the participants were asked to plan safe air travel in two clinical case scenarios, only 16.2% were able to answer both cases correctly.


          This study shows that a standard approach for preflight assessment in patients with COPD is lacking and an active initiative is needed to increase awareness and education for fit to fly concept for COPD among pulmonologists.

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          Most cited references 14

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          Outcomes of medical emergencies on commercial airline flights.

          Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events.
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            Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations.

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              Hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight.

              The aim of the study was to investigate hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight. The effect of a commercial flight, lasting 5 h 40 min, on arterial blood gas levels and symptoms in 18 chronic obstructive pulmonary disease patients with a pre-flight percutaneous oxygen saturation of 94% and self-reported ability to walk 50 m without severe dyspnoea was studied. The arterial oxygen tension (Pa,O2) decreased from sea level to cruising altitude (10.3+/-1.2 versus 8.6+/-0.8 kPa), but, thereafter, except for one patient, remained stable throughout the flight. During light exercise, however, there was further desaturation (percutaneous oxygen saturation 90+/-4 versus 87+/-4%). After 4 h, a decrease in arterial carbon dioxide tension (5.0+/-0.4 versus 4.8+/-0.4 kPa) and an increase in cardiac frequency (87+/-13 versus 95+/-13 beats x min(-1)) were observed. A pre-flight Pa,O2 of >9.3 kPa did not secure an acceptable in-flight Pa,O2. Aerobic capacity showed the strongest correlation with in-flight Pa,O2. In conclusion, following an initial decrease in arterial oxygen tension, chronic obstructive pulmonary disease patients in a stable state of their disease seem to maintain a stable arterial oxygen tension throughout a flight of intermediate duration, except when walking along the aisle. However, a decrease in arterial carbon dioxide tension, indicating compensatory hyperventilation, could imply a risk of respiratory fatigue during longer flights.

                Author and article information

                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of Chronic Obstructive Pulmonary Disease
                22 August 2019
                : 14
                : 1895-1900
                [1 ]Dokuz Eylul University, School of Medicine, Department of Pulmonary and Critical Care , Izmir, Turkey
                [2 ]Department of Internal Medicine, Yuzuncu Yil University, Dursun Odabas Health Center , Van, Turkey
                [3 ]Ataturk University, School of Medicine, Department of Pulmonary Diseases , Erzurum, Turkey
                Author notes
                Correspondence: Begüm ErganDokuz Eylul University School of Medicine, Department of Pulmonary and Critical Care , Izmir35340, TurkeyTel +90 232 412 3801Email
                © 2019 Ergan et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (

                Page count
                Figures: 1, Tables: 3, References: 22, Pages: 6
                Original Research


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