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Hypoxic challenge test applied to healthy children: influence of body positions and exertion on pulse oximetric saturation

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@article{d243719b8dae48fd99fa9c19f7933474,
title = "Hypoxic challenge test applied to healthy children: influence of body positions and exertion on pulse oximetric saturation",
abstract = "BACKGROUND: Commercial aircraft are pressurised to ~2438 m (8000 ft) above sea level that equates breathing 15{\%} oxygen at sea level. A preflight hypoxic challenge test (HCT) is therefore recommended for children with cystic fibrosis or other chronic lung diseases and inflight oxygen is advised if pulse oximetric saturation (SpO2) decreases <90{\%}.OBJECTIVE: Study responses to a modified HCT, encompassing various body positions and light physical activity, reflecting relevant activities of children during flight, with a view to challenge the evidence of the current cut-off.METHODS: Oxygenation, heart rate and ventilation were observed in 34 healthy schoolchildren (17 boys) undergoing a modified HCT, alternating between breathing room air and 15{\%} oxygen in nitrogen while seated, supine, standing and walking at 3 km/h and 5 km/h.RESULTS: Nadir SpO2 <90{\%}, median (range), occurred in 9 subjects sitting, 89{\%} (78-89{\%}); 6 supine, 88.5{\%} (87-89{\%}); 9 standing, 89{\%} (85-89{\%}); 23 walking 3 km/h, 87{\%} (74-89{\%}); and 21 walking 5 km/h, 86{\%} (74-89{\%}). Total time <90{\%} for these subjects in seconds was 20 (10-80) sitting, 30 (10-190) supine, 50 (10-150) standing, 80 (10-260) walking 3 km/h and 125 (10-300) walking 5 km/h. Light exercise in general led to lower SpO2: 91{\%} (77-96{\%}), p<0.0001.CONCLUSIONS: A modified HCT led to moments of desaturation below 90{\%} in various body positions at rest and during light physical activity in healthy schoolchildren. It is questionable whether the international recommended cut-off of 90{\%} for children with chronic lung disease reflects clinical oxygen dependence during flights.",
keywords = "Adolescent, Air Ambulances, Altitude, Child, Chronic Disease, Cross-Over Studies, Cross-Sectional Studies, Exercise, Female, Humans, Lung Diseases, Male, Oximetry, Oxygen, Posture, Prospective Studies, Questionnaires, Spirometry",
author = "Kobbernagel, {Helene Elgaard} and Nielsen, {Kim Gjerum} and Birgitte Hanel",
year = "2013",
month = "8",
doi = "10.1136/archdischild-2012-302763",
language = "English",
volume = "98",
pages = "602--6",
journal = "Archives of Disease in Childhood",
issn = "0003-9888",
publisher = "B M J Group",
number = "8",

}

RIS

TY - JOUR

T1 - Hypoxic challenge test applied to healthy children

T2 - influence of body positions and exertion on pulse oximetric saturation

AU - Kobbernagel, Helene Elgaard

AU - Nielsen, Kim Gjerum

AU - Hanel, Birgitte

PY - 2013/8

Y1 - 2013/8

N2 - BACKGROUND: Commercial aircraft are pressurised to ~2438 m (8000 ft) above sea level that equates breathing 15% oxygen at sea level. A preflight hypoxic challenge test (HCT) is therefore recommended for children with cystic fibrosis or other chronic lung diseases and inflight oxygen is advised if pulse oximetric saturation (SpO2) decreases <90%.OBJECTIVE: Study responses to a modified HCT, encompassing various body positions and light physical activity, reflecting relevant activities of children during flight, with a view to challenge the evidence of the current cut-off.METHODS: Oxygenation, heart rate and ventilation were observed in 34 healthy schoolchildren (17 boys) undergoing a modified HCT, alternating between breathing room air and 15% oxygen in nitrogen while seated, supine, standing and walking at 3 km/h and 5 km/h.RESULTS: Nadir SpO2 <90%, median (range), occurred in 9 subjects sitting, 89% (78-89%); 6 supine, 88.5% (87-89%); 9 standing, 89% (85-89%); 23 walking 3 km/h, 87% (74-89%); and 21 walking 5 km/h, 86% (74-89%). Total time <90% for these subjects in seconds was 20 (10-80) sitting, 30 (10-190) supine, 50 (10-150) standing, 80 (10-260) walking 3 km/h and 125 (10-300) walking 5 km/h. Light exercise in general led to lower SpO2: 91% (77-96%), p<0.0001.CONCLUSIONS: A modified HCT led to moments of desaturation below 90% in various body positions at rest and during light physical activity in healthy schoolchildren. It is questionable whether the international recommended cut-off of 90% for children with chronic lung disease reflects clinical oxygen dependence during flights.

AB - BACKGROUND: Commercial aircraft are pressurised to ~2438 m (8000 ft) above sea level that equates breathing 15% oxygen at sea level. A preflight hypoxic challenge test (HCT) is therefore recommended for children with cystic fibrosis or other chronic lung diseases and inflight oxygen is advised if pulse oximetric saturation (SpO2) decreases <90%.OBJECTIVE: Study responses to a modified HCT, encompassing various body positions and light physical activity, reflecting relevant activities of children during flight, with a view to challenge the evidence of the current cut-off.METHODS: Oxygenation, heart rate and ventilation were observed in 34 healthy schoolchildren (17 boys) undergoing a modified HCT, alternating between breathing room air and 15% oxygen in nitrogen while seated, supine, standing and walking at 3 km/h and 5 km/h.RESULTS: Nadir SpO2 <90%, median (range), occurred in 9 subjects sitting, 89% (78-89%); 6 supine, 88.5% (87-89%); 9 standing, 89% (85-89%); 23 walking 3 km/h, 87% (74-89%); and 21 walking 5 km/h, 86% (74-89%). Total time <90% for these subjects in seconds was 20 (10-80) sitting, 30 (10-190) supine, 50 (10-150) standing, 80 (10-260) walking 3 km/h and 125 (10-300) walking 5 km/h. Light exercise in general led to lower SpO2: 91% (77-96%), p<0.0001.CONCLUSIONS: A modified HCT led to moments of desaturation below 90% in various body positions at rest and during light physical activity in healthy schoolchildren. It is questionable whether the international recommended cut-off of 90% for children with chronic lung disease reflects clinical oxygen dependence during flights.

KW - Adolescent

KW - Air Ambulances

KW - Altitude

KW - Child

KW - Chronic Disease

KW - Cross-Over Studies

KW - Cross-Sectional Studies

KW - Exercise

KW - Female

KW - Humans

KW - Lung Diseases

KW - Male

KW - Oximetry

KW - Oxygen

KW - Posture

KW - Prospective Studies

KW - Questionnaires

KW - Spirometry

U2 - 10.1136/archdischild-2012-302763

DO - 10.1136/archdischild-2012-302763

M3 - Journal article

VL - 98

SP - 602

EP - 606

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

SN - 0003-9888

IS - 8

ER -

ID: 43625418