Flying Recommendation for MD

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air travel recommendation
Atmospheric pressure in a plane is lower than outside 0.6 atmosphere versus 1 atmosphere
Travelling with a Ventilator
The lower atmospheric pressure is the lower limit to obtain an "acceptable" oxygen arterial blood pressure in normal healthy subjects.
This means that respiratory problems may be exacerbated in a plane but rarely caused by the lower pressure.
Even  healthy persons have O2 desaturations in a plane, but usually not so deep.
When persons are hypercapnic (arterial carbon dioxide pressure>50mmHg), the relationship between paO2 and SpO2 is deleterious to the patient. This means that the risk for O2 desaturations is higher when pCO2 is high.
Thus it should be useful to prepare an O2 connection to the BIPAP before any flight. In patients known to have risks of SEVERE O2 desaturations, a pulse oxymeter is useful in the plane. Otherwise the risk is to panic staff when patients have slight desaturations. It is better to be unaware of slight desaturations because even normal people desaturate in the plane without knowing it. However, O2 desaturations to <75% requires to prepare future flights carefully as described above.
The question is whether one has a normal CO2 tension before boarding the plane.
The recommendation is to take and to USE the BIPAP in the plane.
If there is O2 desaturations, then O2 administration is useful WITH BIPAP
Never replace BIPAP with O2, but add O2 to BIPAP
take off
Flying with your ventilator is not a problem. The mouthpiece is readily clamped to tray table or elsewhere.
Plane Travel Recommendation by Deborah Robins is licensed under Creative Commons Attribution-NonCommercial 4.0 International License NB Not to be construed as medical advice
Sources:   Toussaint, M. Plane Travel Recommendation. (personal communication, June 23, 2008) Dellios, C. (personal communication, Aug 23, 2017)
Always take ventilators in the cabin. Never pack in luggage. Forewarn the airline just as you do with your wheelchair. For booking and flying have a doctor's letter describing: the make/model and confirmation of sealed batteries, no oxygen etc. Bring enough fully charged batteries with you to power your portable ventilator.
Scan these general flying tips:
If needed, connecting O2 to the valve in rear of the Trilogy, automatically keeps volumes constant with oxygen flows of up to 16 LPM.