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Flugmedizin · Tropenmedizin · Reisemedizin - FTR 2014; 21(2): 69-78
DOI: 10.1055/s-0034-1376162
Flugmedizin
© Georg Thieme Verlag Stuttgart · New York

Flugreisetauglichkeit von vorerkrankten Patienten – Beratung von Reisenden mit internistischen Erkrankungen

Flight travel fitness of passengers with pre-existing diseases – counseling of travelers with internal medicine disorders
Jörg Siedenburg
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Publication Date:
22 April 2014 (online)

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Flugreisen werden zunehmend von Reisenden mit Vorerkrankungen oder sogar mit schweren gesundheitlichen Einschränkungen angetreten. Ärzte sollten bei Patienten, deren Kompensationsfähigkeit krankheitsbedingt eingeschränkt ist, deren Flugreisetauglichkeit vor Antritt einer Flugreise beurteilen und gegebenenfalls zusätzliche Maßnahmen vornehmen. Die vorliegende Arbeit informiert über allgemeine aktuelle Empfehlungen zur Flugreisetauglichkeit sowie über spezielle Empfehlungen zu den wichtigen internistischen Krankheitsbildern.

More and more air travel is undertaken by travelers with pre-existing disease or even severe clinical disorders. Physicians should be aware that such patients might have limited capabilities to cope with the physiological challenges of air travel, such as reduction of ambient pressure to a pressure altitude equal to 1600-2400 m with subsequent mild hypoxia and expansion of trapped gases, low relative humidity, limited space, time shift, travel related stress etc. Therefore, it is prudent to assess the flight travel fitness of such passengers. In this context cardiac and pulmonary disorders deserve special attention. Compensation of physiological challenges can be augmented by means like additional oxygen. The article informs about actual recommendations for assessment of flight travel fitness and presents special advice for the most important internal medicine disorders.

Key words

flight travel fitness - pre-existing disease - internal medicine disorders
 

  • Literatur

  • 1 Siedenburg J. Flugreisen mit gesundheitlichen Einschränkungen. Flug u Reisemed 2013; 20: 272-279
    Thieme ConnectSearch in Google Scholar
  • 2 Aerospace Medical Association, Aviation Safety Committee, Civil Aviation Subcommittee. Cabin cruising altitude for regular transport aircraft. Aviat Space Environ Med 2008; 79: 433-439
    CrossrefSearch in Google Scholar
  • 3 Siedenburg J. Flugreisetauglichkeit bei Repatriierungen. Arbeitsmed Sozialmed Umweltmed 2011; 46: 539-555
    Search in Google Scholar
  • 4 International Air Transport Association. Passenger Care. In: IATA: Medical Manual. 6th Ed 2013: 50-60
    Search in Google Scholar
  • 5 Bagshaw M. Inflight medical incidents. Presentation at ECAC Symposium Selected Aspects of Passenger Health in Air Travel, Dubrovnik, Croatia, October. 2002
    Search in Google Scholar
  • 6 Aerospace Medical Association Medical Guidelines Task Force. Medical Guidelines for Airline Travel, 2nd ed. Aviat Space Environ Med 2003; 74 (Suppl. 05) 1-19
    Search in Google Scholar
  • 7 World Health Organization. Travellers with medical conditions or special needs. In: International travel and health. Geneva: 2010: 19-21
    Search in Google Scholar
  • 8 Siedenburg J. Kompendium Flug- und Reisemedizin. Norderstedt: Books on Demand; 2010
    Search in Google Scholar
  • 9 Smith D, Toff W, Joy M et al. Fitness to fly for passengers with cardiovascular disease. Heart 2010; 96 (Suppl. 02) 1-16
    Search in Google Scholar
  • 10 Baer FM, Rosenkranz S. Koronare Herzkrankheit und akutes Koronarsyndrom. In: Erdmann E, Hrsg. Klinische Kardiologie. 7. Aufl. Berlin: Springer; 2008: 45-45
    Search in Google Scholar
  • 11 Böhm M, Er F, Kindermann M, Laufs U, Scheller B. Herz und Koronarkreislauf. In: Siegenthaler W, Blum HE, Hrsg. Klinische Pathophysiologie. 9. Aufl. Stuttgart: Thieme; 2006: 599-599
    Search in Google Scholar
  • 12 British Thoracic Society Standards of Care Committee. Managing passengers with respiratory disease planning air travel: British Thoracic Society recommendations. Thorax 2002; 57: 289-304
    CrossrefSearch in Google Scholar
  • 13 Bachmann K. Herzkrankheiten und Fliegen. Z Ärztl Fortbild Qualitatssich 1999; 93: 528-532
    Search in Google Scholar
  • 14 Möllmann H, Szardien S, Kempfert J et al. Myokardrevaskularisation. Internist 2012; 53: 1063-1075
    CrossrefSearch in Google Scholar
  • 15 Harinck E, Hutter PA, Hoorntje TM et al. Air travel and adults with cyanotic congenital heart disease. Circulation 1996; 93: 272-276
    CrossrefSearch in Google Scholar
  • 16 Keystone JS, Kozarsky PE, Stegemann S. Gesundheitsempfehlungen für Fernreisende. In: Dietel M, Suttorp N, Zeitz M, Hrsg. Harrisons Innere Medizin. 18. Aufl. Berlin: ABW; 2012: 1118-1127
    Search in Google Scholar
  • 17 Sevenich C. Implantierte Herzschrittmacher und Defibrillatoren auf Reisen – Umgang mit möglichen technischen Fehlfunktionen. Flug u Reisemed 2013; 20: 286-292
    Thieme ConnectSearch in Google Scholar
  • 18 Bradley PD, Normand E. Single even upsets in implantable cardioverter defibrillators. IEEE Trans Nucl Sci 1998; 45: 2929-2940
    CrossrefSearch in Google Scholar
  • 19 Norii T, Freeman TH, Alseidi A et al. Pressurized flight immediately after splenic infarction in two patients with the sickle cell trait. Aviat Space Environ Med 2011; 82: 58-60
    CrossrefSearch in Google Scholar
  • 20 Domej W. Lungenerkrankungen und Höhe. In: Küpper T, Ebel K, Gieseler U. Moderne Berg- und Höhenmedizin. Stuttgart: Gentner; 2010: 480-492
    Search in Google Scholar
  • 21 UK Parliament, House of Lords. Air travel and health. 5th Report. 2000
    Search in Google Scholar
  • 22 Dierkesmann R. Lungenerkrankungen und Fliegen. Z Arztl Fortbild Qualitatssich 1999; 93: 528-532
    Search in Google Scholar
  • 23 Domej W, Haditsch B, Schwaberger G. Kritische Beurteilung der O2-Versorgung des Organismus durch Pulsoxymetrie. Alpinmed Rundbr 2011; 44: 14-15
    Search in Google Scholar
  • 24 Muhm JM. Predicted arterial oxygenation at commercial aircraft cabin altitudes. Aviat Space Environ Med 2004; 75: 905-912
    Search in Google Scholar
  • 25 Hampson NB, Kregenow DA, Mahoney AM et al. Altitude exposures during commercial flight: a reappraisal. Aviat Space Environ Med 2013; 84: 27-31
    CrossrefSearch in Google Scholar
  • 26 Ahmedzai S, Balfour-Lynn IM, Bewick T et al. Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations. Thorax 2011; 66 (Suppl. 01) 1-30
    Search in Google Scholar
  • 27 Smith TG, Chang RW, Robbins PA, Dorrington KL. Commercial air travel and in-flight pulmonary hypertension. Aviat Space Environ Med 2013; 84: 65-67
    CrossrefSearch in Google Scholar
  • 28 Mortazavi A, Eisenberg MJ, Langleben D et al. Altitude-related hypoxia: risk assessment and management for passengers on commerical aircraft. Aviat Space Environ Med 2003; 74: 922-927
    Search in Google Scholar
  • 29 Dillard TA, Bansal AK. Commentary: pulse oximetry during airline travel. Aviat Space Environ Med 2007; 78: 143-144
    Search in Google Scholar
  • 30 Akerø A, Christensen CC, Edvardsen A et al. Pulse oximetry in the preflight evaluation of patients with chronic obstructive pulmonary disease. Aviat Space Environ Med 2008; 79: 518-524
    CrossrefSearch in Google Scholar
  • 31 Chetta A, Castagnetti C, Aiello M et al. Walking capacity and fitness to fly in patients with chronic respiratory disease. Aviat Space Environ Med 2007; 78: 789-792
    Search in Google Scholar
  • 32 Dillard TA, Moores LK, Bilello KL, Phillips YY. The preflight evaluation. A comparison of the hypoxia inhalation test with hypobaric exposure. Chest 1995; 107: 352-357
    CrossrefSearch in Google Scholar
  • 33 Gong Jr H, Tashkin DP, Lee EY, Simmons MS. Hypoxia-altitude simulation test. Evaluation of patients with chronic airway obstruction. Am Rev Respir Dis 1984; 130: 980-986
    Search in Google Scholar
  • 34 Thamm M, Voswinckel R, Gall H et al. Air Travel Is Safe and Well Tolerated in Clinically Stable PH Patients. Am J Rep Crit Care Med 2009; 179
    Search in Google Scholar
  • 35 Ghofrani HA, Distler O, Gerhardt F et al. Therapie der pulmonal arteriellen Hypertonie (PAH) – Empfehlungen der Kölner Konsensus-Konferenz 2010. Dtsch Med Wochenschr 2010; 135 (Suppl. 03) 87-101
    Thieme ConnectSearch in Google Scholar
  • 36 Coker RK, Partridge MR. What happens to patients with respiratory disease when they fly?. Thorax 2004; 59: 919-920
    CrossrefSearch in Google Scholar
  • 37 Schwartz JS, Bencowitz HZ, Moser KM. Air travel hypoxemia with chronic obstructive pulmonary disease. Ann Intern Med 1984; 100: 473-477
    CrossrefSearch in Google Scholar
  • 38 Dillard TA, Berg BW, Rajagopal KR et al. Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. Ann Intern Med 1989; 111: 362-367
    CrossrefPubMedSearch in Google Scholar
  • 39 Graham WG, Houston CS. Short-term adaptation to moderate altitude. Patients with chronic obstructive pulmonary disease. JAMA 1978; 240: 1491-1494
    CrossrefSearch in Google Scholar
  • 40 Virchow JC. Asthma – Geschichtliche Entwicklung, Status quo und Ausblick. Pneumologie 2010; 64: 541-549
    Thieme ConnectSearch in Google Scholar
  • 41 Coker R. Air Travel and Respiratory Disease. Presentation at IATA Conference on Cabin Health, Geneva. 2002
    Search in Google Scholar
  • 42 Informationsdatenbank auf. http://www.europeanlung.org/de/
  • 43 Siedenburg J. Infektionserkrankungen und internationaler Luftverkehr. Arbeitsmed Sozialmed Umweltmed 2010; 45: 673-677
    Search in Google Scholar
  • 44 Nickelsen T. Die Endokrinologie der Zeitverschiebung. In Hermann H: Lehrgangsskript Fliegerarztlehrgang 3. Deutsche Akademie für Flugmedizin 1993;
    Search in Google Scholar