Leigh M Seccombe
Matthew J Peters
Between 1976 and 2008, the number of Australians travelling overseas increased six-fold. Every day, over 16 000 Australians travel overseas and there are 120 000 domestic passenger movements.1,2 Among potential travellers with the means and desire to fly are many who are enjoying longer survival with chronic lung disease, often with significant comorbidity.
Commercial air travel is cheap and accessible. Many
patients living ever better lives despite chronic lung
disease wish to, and do, fly. Statistics tell us that
misadventure is rare and that flight must be safe for the
majority of people.
To assist the general practitioner in assessing and advising
patients with lung disease on issues relating to the risks
associated with air travel.
An aircraft cabin is a low pressure, hypoxic environment
that challenges those with lung disease for up to 15 hours
at a time. Patients with very poor performance status
or severe lung disease should not fly or must fly with
oxygen. Selected patients with moderately severe COPD
or other chronic lung disease will benefit from specialist
review and cabin hypoxia simulation. The risk of venous
thromboembolism can be reduced if the patient is risk
stratified and simple interventions applied. Perhaps the
most important principle is that patients must be clinically
stable at the time they fly.
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