Patients with lung disease - Fit to fly?

BACKGROUND Commercial air travel is cheap and accessible. Many patients living ever better lives despite chronic lung disease wish to, and do, fly. Statistics tell us that misadventure is rare and that flight must be safe for the majority of people. OBJECTIVE To assist the general practitioner in assessing and advising patients with lung disease on issues relating to the risks associated with air travel. DISCUSSION An aircraft cabin is a low pressure, hypoxic environment that challenges those with lung disease for up to 15 hours at a time. Patients with very poor performance status or severe lung disease should not fly or must fly with oxygen. Selected patients with moderately severe COPD or other chronic lung disease will benefit from specialist review and cabin hypoxia simulation. The risk of venous thromboembolism can be reduced if the patient is risk stratified and simple interventions applied. Perhaps the most important principle is that patients must be clinically stable at the time they fly.