Travelling (staying) at high altitude

Question

Dear expert team,

I would like to know from a medical point of view if the following trip would be possible for me or if it bears too many risks… I have friends in Quito and would like to visit them with two friends of mine. Quito is located at an altitude of 2900m above sea level. My current health status is as follows:
FEV1 25-30%, VC around 50%, currently I do not need [extra] oxygen only when I have an infection. For the trip I would use extra oxygen in Quito for the first 24 hours and during the flight as well. Is it sufficient to use oxygen in order to minimise the risk of altitude sickness e.g.? What kind of other risks does altitude carry for CF individuals?
With answering my question you would certainly help me to take a decision.

Many thanks.

Answer

Hello,

Generally speaking a long-distance flight and staying at high altitude means that you are exposed to a low atmospheric pressure. The higher you are the lower is the oxygen partial pressure.

In general, the cabin pressure in a plane corresponds to a stay in an altitude of 8000ft which is about 2400m. Quito is located even higher.

For estimating your risk one should not only know the FEV1 and vital capacity but your current blood gas analysis with PO2, PCO2 and PH values as well. Additionally, it is important that you do not have any accompanying diseases (e.g. cardiac) which would aggravate a possible compensation at altitude.

Further to the values you indicated the permanent use of extra oxygen during the flight and the travel destination seems to be advised in any case. The amount of extra oxygen to be given should be determined before the trip by considering the blood gas analysis. A further problem during a flight trip is the very dry and often cold air in the plane which can promote airways stenosis and infections as well.

In addition to using extra oxygen during the flight it is important to drink enough non-alcoholic beverages.

Once you have reached Quito you should be aware of the fact that even at rest it is much more effort to be active than at home. Therefore, it is highly recommended to get used to the altitude slowly and not to be too active, especially at the beginning.

I do not want to discourage you to do this trip but it should be prepared very well. I strongly recommend to discuss with your CF clinic how much oxygen you need, which medicaments you should take with you and if you should also take with you a nebuliser, etc.

Best regards,
Dr. W. Gleiber

24.02.2010