Predictive Calculation of the Arterial Gasometric Variables during the Transfer of Respiratory Patients by Air

摘要

The latest recommendations published for the air transport of patients with respiratory pathology are those of the British Thoracic Society. They present a management protocol for the patients based on the basal pulse oximetry at sea level, indicating those patients who will require supplementary oxygen, but without listing the specific contraindications to flying with the exception of current closed pneumothorax or active tuberculosis. A number of formulae exist that attempt to predict in-flight hypoxaemia but which, at the end of the day, concluded with the recommendation of whether or not to administer supplementary oxygen at two liters per minute, without individualizing the dose. We propose an analysis of the clinical situation of the patient, performing arterial gasometry at ground level and calculating the alveolar-arterial oxygen gradient. Using these Data in the formula that we propose, we individualize the management of the patient during air travel, optimizing the air transport of cases of respiratory pathology. This will avoid delay in the transfer of patients with acute respiratory pathology by ensuring a correct oxygen delivery and facilitating the early detection of complications. This is a group of particular importance in evacuations in the military environment, in both pressurized and non-pressurized transport. In cases of chronic respiratory pathology, hyperoxia and the consequent retention of carbon dioxide, an ever-present risk in this population group will be avoided. Their individualized management will make air transfer possible for a large group of patients for whom there currently exist general guidelines for supplementary oxygen delivery without quantifying this in an individualized manner and which can, therefore, lead to difficulties in the control of undesirable effects.