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

Figures & data

Table 1 Demographics of survey participants

	n	%
Gender
Female	148	61.2
Male	94	38.8
Age (years)
<31	41	17.0
31–40	69	28.5
41–50	86	35.5
51–60	40	16.5
>60	6	2.5
Year of medical school graduation
>2009	47	19.4
2000–2009	80	33.1
1990–1999	79	32.6
1980–1989	32	13.2
<1980	4	1.7
Career^a
Academician	87	36.0
Specialist	108	44.6
Resident	47	19.4
Workplace
University hospital	106	43.8
Education and research hospital	74	30.6
State hospital	37	15.3
Other including private practice	25	10.3

Notes: ^aAll are pulmonologists except 4 physicians: general practitioner (1), family physician (1), chest surgeon (1), internist (1).

Table 2 Clinical practices of participants

	n	%
Average number of COPD patients examined per week
<20	76	31.4
20–40	69	28.5
>40	97	40.1
Average percentage of patients with moderate to severe COPD
<25%	30	12.4
25–50%	115	47.5
51–75%	86	35.5
>75%	11	4.6
Informing routinely for possible risks of air travel	74	30.6
Performing preflight assessment with any method	148	61.2
Ever preparing a fit to fly report	83	34.3
Ever prescription of supplemental oxygen for flight	122	50.4

Figure 1 Distribution of tests used for preflight evaluation.

Note: Other methods were predictive equations and exercise tests.
Abbreviations: 6MWT, 6 min walk test; ABG, arterial blood gas ; K_CO, transfer coefficient for carbon monoxide; PFT, pulmonary function tests; SaO2, oxygen saturation with pulse oximetry.

Box 1 Clinical case scenarios

Case 1 (*correct answer rate 24.8%) A 64-year-old male patient was followed-up for COPD for the last 10 years with an FEV1 of 1.2 L (40% of predicted). He had a history of exacerbation twice a year. He said that he had planned a holiday with 6 hours flight. What do you recommend to the patient if his oxygen saturation was 95% measured with pulse oximetry in room air? a. I would say he is fit to fly b. I would suggest him to use oxygen on the plane c. I would suggest an arterial blood gas analysis, if PaO2 >60 mmHg he is fit to fly d. I would advise him not to fly without further evaluation*

Case 2 (*correct answer rate 70.2%) A 72-year-old patient with advanced COPD reported that he wanted to go to Moscow to attend his grandson’s wedding. The flight was expected to be around 3 hours. You have learned that the patient is under continuous oxygen treatment at home, using 2 L/min 16 hours a day. What do you recommend for flight? a. I would say that air travel is dangerous in chronic respiratory failure, and he should not fly b. I would inform him that airline companies would not allow him to fly because he was receiving oxygen treatment c. I would allow him to fly after getting approval from airline company and adjusting supplemental oxygen therapy to 4 L/min during flight* d. I would allow him to fly with the same level of supplemental oxygen therapy (2 L/min) with portable oxygen concentrator after getting approval from the airline company