Assessment of fitness to fly in patients with respiratory disease

To keep a pressure that allows human life, commercial airplanes need to pressurize their cabins, which mean an equilibration between the fuselage structure, the fuel consumption and the operational costs. In this condition they can only maintain cabin pressures of a simulated altitude of 8,000 feet. The Dalton's law indicates that the inspired partial pressure of oxygen is severely reduced, meaning a real hypoxic condition for humans. Another physical modifications that take place in this artificial media, such as low air humidity and reduced vital capacity because of abdominal gas decompression. These alterations are well tolerated by normal individuals, but this is not the case for chronic respiratory patients. They suffer a severe deterioration of their oxygenation. There are only limited studies about patients in these conditions. On the other hand, control has not been obligatory and the decision to allow the flight depends on the pulmonary physician's advice or on the patient's own decision. In this article we discuss general concepts about this merging problem and describe some rational ways to evaluate these patients based on available information. © 2006 Sociedad Chilena de Enfermedades Respiratorias.