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(Chest. 1995;108:1292-1296.)
© 1995 American College of Chest Physicians

The Safety of Air Transportation of Patients With Advanced Lung Disease

Experience With 21 Patients Requiring Lung Transplantation or Pulmonary Thromboendarterectomy

Mordechai R. Kramer MD, FCCP1; Daniel J. Jakobson MD2; Chaim Springer MD1; and Yoel Donchin MD3

1 From the Institute of Pulmonology, Hadassah University Hospital, Jerusalem, Israel
2 From the Department of Medicine, Hadassah University Hospital, Jerusalem, Israel
3 From the Department of Anesthesiology, Hadassah University Hospital, Jerusalem, Israel

Air travel can cause severe respiratory decompensation in a patient with advanced lung disease due to high altitude hypoxemia. We report our experience in flying 21 patients with advanced lung disease to a medical center remote from Israel for lung transplantation or pulmonary thromboendarterectomy (PTE). All patients had severe lung disease with marked hypoxemia (PaO2, 40 to 59) and 16 had significant pulmonary hypertension. Nine patients (with emphysema and pulmonary fibrosis) required single lung transplant, four (with cystic fibrosis and emphysema) required double-lung transplant, six (with primary or secondary pulmonary hypertension) required heart-lung transplant, and two (with major vessel pulmonary thrombosis) required PTE. All patients were flown by commercial aircraft to centers located 2,634 to 13,181 km away from Israel. Length of flight was between 4 and 21 h. Patients were given oxygen supplementation during the flight and were monitored by portable oximeters. All but three patients were hemodynamically stable and 19 of them were escorted by physicians. All but one hemodynamically unstable patient who died on board arrived safely at their destinations. We conclude that with careful preparation, sufficient oxygen supply, oximetric monitoring, and medical escort, almost any patient with severe lung disease can travel by air to any necessary destination.

Key Words: air transport • COPD • emphysema • high altitude • hypoxemia • lung transplantation

Submitted on October 12, 1994
Accepted on June 7, 1995




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