Evaluating hypoxia during air travel in healthy infants

Up to a third of ex-preterm infants flying near term exhibit pulse oxygen saturation (SpO 2 ) of less than 85% during air travel. A hypoxia challenge test (HCT) is recommended to evaluate the requirement for in-flight supplemental O 2 . The validity of the HCT in healthy, term infants has not been reported. This study aimed to characterise the in-flight hypoxia response and the accuracy of the HCT to predict this response in healthy, term infants in the first year of life. Infants (n=24: (15 male)) underwent a HCT prior to commercial air travel during which parents monitored SpO 2 . Thirty-two flights were undertaken with six infants completing multiple flights. The median in-flight SpO 2 nadir was 87% and significantly lower than the HCT SpO 2 nadir (92%: p 2 2 less than 85%. There was marked variability in the in-flight SpO 2 in the six infants who undertook multiple flights, and for three of these infants, the SpO 2 nadir was both above and below 85%. We report that in healthy term infants an in-flight SpO 2 below 85% is common and can vary considerably between flights and that the HCT poorly predicts the risk of in-flight hypoxia (SpO 2 2 less than 85% during air travel further research is needed to clarify whether this is an appropriate cut-off in this age group.