Patients with emphysema in addition to COPD are also at a slightly higher risk of developing a pneumothorax during air travel due to pressure changes, although this does not commonly occur. As in patients without COPD, longer air travel can increase the risk for deep venous thrombosis and pulmonary embolism.
However, for travelers with lung conditions such as chronic obstructive pulmonary disease (COPD) and emphysema, decreased oxygen levels inside airplane cabins can create a number of problems not experienced by healthy passengers. To ensure safe travels for these passengers, proper precautions must be taken.
National Emphysema Foundation (NEF)
Breathing at higher elevations can be difficult for COPD sufferers because your body needs to work harder to take in the same amount of oxygen as it does at elevations closer to sea level. This strains your lungs.
Having a lung condition should not stop you from travelling by air. Whether you are going on holiday, a business trip or a visit to family and friends, it should be possible to make the necessary arrangements - as long as you plan ahead.
Traveling by airplane exposes people to decreased air pressure and lower than normal oxygen levels. For most people, these changes are not noticeable.
Oxygen levels in an airplane cabin fall with increasing altitude and at high-altitude destinations, resulting in danger for persons with a preexisting pulmonary disorder. Stabilization and correct management of pulmonary conditions before travel is important.
Dr Khabbaza: Air travel subjects patients with COPD to lower oxygen pressures in the cabin, which is similar to breathing about 15% oxygen at sea level. Patients with COPD have a lower respiratory reserve and are at a higher risk of developing hypoxemia during air travel.
an infectious disease (e.g. chickenpox, flu), including COVID-19. decompression sickness after diving (sometimes called 'the bends') increased pressure in the brain (due to bleeding, injury or infection)
Air pressure is lower at higher altitudes, which means your body takes in less oxygen. Airlines “pressurize” the air in the cabin, but not to sea-level pressures, so there's still less oxygen getting to your body when you fly, which can make you feel drained or even short of breath.
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What causes exacerbations? COPD can get worse from an infection (such as a cold or pneumonia), from being around someone who is smoking, or from air pollution.
Air pollution, chemical fumes, and dust also can make emphysema worse. Stay up to date on your COVID-19 vaccines.
Exacerbations are usually caused by a viral or bacterial lung infection, but they may also be triggered by things or situations that make it difficult for you to breathe, such as smoking or being exposed to smoke or air pollution. The signs of a COPD exacerbation go beyond your day-to-day COPD symptoms.
Resting Pulse Oximetry
Values >95% on room air suggest that inflight hypoxemia is unlikely and that further evaluation is likely not necessary. Patients with saturations <92% on room air at rest should receive supplemental oxygen inflight, because they are at high risk of hypoxemia at altitude.
Your middle ear connects to the back of your nose via the eustachian tube, which can become blocked by congestion, preventing pressure equalization. When you fly and the air pressure around you changes, the pressure within your blocked sinuses or ears stays the same, causing a great deal of pain.
The hypoxic challenge test, also known as a fit to fly test, recreates the oxygen levels on an aeroplane and measures how your body responds. The test involves breathing in air containing less oxygen than normal and seeing how it affects you in a controlled environment.
As much as possible, avoid breathing allergens and environmental toxins, such as chemical fumes or secondhand smoke. Avoid extremes in temperature. Activity in very hot and humid or very cold conditions may magnify the dyspnea caused by chronic lung diseases.
Choose a seat in the middle of the plane. As the air circulates across the rows and not up and down the plane, some experts believe the worst air is in the front or the back of the plane. Stay well hydrated by drinking lots of fluids (water or fruit juice) and avoiding caffeine and alcohol, which will dehydrate you.
Planes have lower oxygen levels
Still, the amount of air pumped inside doesn't result in quite as much oxygen as you'd normally breathe at sea level. "The cabin is only pressurized to simulate an elevation of 6,000 to 8,000 feet on modern jets," says Brent Blue, a doctor and longtime pilot.
Now, if you need to delay your trip for illness, you can usually do so without penalty. Most airlines now allow changes with Economy tickets. When you are well enough to travel, you'll just have to pay the difference in cost for an airline ticket (if there is one for your new dates).
Authors of a 2011 study concluded that people with severe or exacerbated COPD should not travel to elevations above 2,000 m (about 6,500 ft), but that people with stable COPD may be able to comfortably travel to elevations of 2,000–3,000 m (around 6,500–10,000 ft).
In emphysema, the inner walls of the lungs' air sacs (alveoli) are damaged, causing them to eventually rupture. This creates one larger air space instead of many small ones and reduces the surface area available for gas exchange. Emphysema is a lung condition that causes shortness of breath.