Table 1.
Travel guidelines for patients with specific respiratory conditions
| Disease | Recommendations |
|---|---|
| COPD: chronic bronchitis and emphysema | Arrange inflight oxygen if indicated; carry bronchodilators in hand luggage; consider PFT (FEV1) in patients with severe COPD |
| Asthma | Hand carry short-acting inhalers; advise to take a course of oral steroid with them for any emergencies during trip; delay travel if labile condition |
| Interstitial lung disease (idiopathic pulmonary fibrosis and sarcoidosis) | Evaluate need for in-flight oxygen therapy |
| Bronchiectasis and cystic fibrosis | Control of lung infection with appropriate antibiotics; measures to loosen and clear secretions; adequate hydration; consider aerosolized rhDNAse to reduce sputum viscosity; medical oxygen if indicated |
| Pneumothorax | Diagnose and correct underlying etiology; delay travel until resolved |
| Pulmonary hypertension | Anticoagulation, evaluation for in-flight oxygen; restrict exercise during flight |
| Pleural effusion | Large effusion should be drained 10–14 days before flight for diagnostic and therapeutic purposes; consider repeating chest radiograph before trip |
| Neuromuscular disease (spinal cord injury, obesity hypoventilation syndrome, muscular dystrophy) | Arrange manual suctioning equipment, medical oxygen, and ventilator capabilities; some patients may require tracheostomy before trip |
| Tracheostomy | Humidification of inspired air; adequate hydration; suctioning |
| Patients on long-term home oxygen therapy | May need to increase flow rate from 1 to 2 L.min−1 to 4 L.min−1 |
| Recent exacerbation of any chronic respiratory disease | Delay travel until stabilized |