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The ambient conditions inside commercial aircraft expose passengers to hypobaric hypoxia often approaching the altitude equivalent of 8,000 feet (2,438m) above sea level. There have been reports of s...udden natural death associated with commercial air travel. The major causes of such natural deaths were cerebro- and cardio-vascular diseases. The aim of this study was to clarify the relationship between cabin pressure and pathophysiological changes in passengers at an airport and during flight. We measured inflight cabin altitude and cabin pressure recorded from a handheld barometer or a commercially available altimeter (Protrek), and also the arterial oxygen saturation (%SpO2) by Nonin finger pulse oximeters in 31 healthy subjects (22 males and 9 females), over 41 scheduled commercial flights between Tokyo and Fukuoka, in Japan. Holter ECGs for 2 males were also recorded to study autonomic activity, which was evaluated by heart rate variability analysis. Steady state cabin pressure in the 41 flights was 804.9 ± 38.3hPa. %SpO2 decreased from 97.0 ± 1.0% to 91.0 ± 2.7%. While the cabin pressure was decreasing after takeoff and increasing before landing, RR50 and HF were significantly higher than before takeoff and during horizontal flight. However, LF/HF showed a decrease at decompression and compression, and increased during steady state lower cabin pressure. These results suggest that hypoxemia and unstability in autonomic nervous system activity may induce vasospasm of the vessels with an endothelial dysfunction in passengers during air travel.show more
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