Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study

Abstract Aim We investigated whether a commercial bi‐level positive airway pressure (BPAP) device, would improve peripheral oxygen saturation (SpO2) during recreational aviation up to 12,500 feet without supplemental oxygen. Ten adults with recreational flight experience (age:47 ± 14; female = 5) co...

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Main Authors: Jenna L. Taylor, Aidan K. Downs, Crystal L. Danner, J. Hunter Downs III, Josh Donkor, Jessica I. Johnston, Douglas Rozendaal, Peter L. Larsen, Bruce D. Johnson, Douglas T. Summerfield
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Physiological Reports
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Online Access:https://doi.org/10.14814/phy2.70210
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author Jenna L. Taylor
Aidan K. Downs
Crystal L. Danner
J. Hunter Downs III
Josh Donkor
Jessica I. Johnston
Douglas Rozendaal
Peter L. Larsen
Bruce D. Johnson
Douglas T. Summerfield
author_facet Jenna L. Taylor
Aidan K. Downs
Crystal L. Danner
J. Hunter Downs III
Josh Donkor
Jessica I. Johnston
Douglas Rozendaal
Peter L. Larsen
Bruce D. Johnson
Douglas T. Summerfield
author_sort Jenna L. Taylor
collection DOAJ
description Abstract Aim We investigated whether a commercial bi‐level positive airway pressure (BPAP) device, would improve peripheral oxygen saturation (SpO2) during recreational aviation up to 12,500 feet without supplemental oxygen. Ten adults with recreational flight experience (age:47 ± 14; female = 5) completed a standardized flight profile in an unpressurised aircraft, involving randomized crossover design at 8,000 feet and 12,500 feet with BPAP or control. SpO2, middle cerebral artery velocity (MCAv), heart rate (HR), respiratory rate (RR), and relative tidal volume (TV) index were measured continuously. Psychomotor vigilance test (3‐min) assessed reaction time halfway through taxi and altitude stages. Altitude significantly (p < 0.05) decreased mean SpO2, MCAv, and RR, and increased TV index and HR. There was no effect of altitude (p > 0.05) on reaction time. BPAP increased mean SpO2 at 8,000 feet [Control: 92 ± 1%; BPAP: 94 ± 2%; mean difference (MD) = 2 ± 2%; p = 0.002] and 12,500 feet [Control: 86 ± 4%; BPAP: 89 ± 4%; MD = 2 ± 3%; p = 0.013]. BPAP lowered MCAv at 8,000 feet [Control: 53 ± 10 cm/s; BPAP: 50 ± 9 cm/s; MD = ‐3 ± 2 cm/s; p = 0.001] and 12,500 feet [Control: 52 ± 10 cm/s; BPAP: 50 ± 8 cm/s; MD = ‐2 ± 3 cm/s; p = 0.041]. BPAP increased TV index at 8,000 feet (Control: 6.6 ± 1.3; BPAP:8.1 ± 1.8; MD = 1.9 ± 0.8; p < 0.001) but not 12,500 feet, without effect on RR or reaction time. This study provides preliminary results that BPAP may improve mean SpO2 for recreational aviators up to 12,500 feet without supplemental oxygen.
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spelling doaj-art-938818c5cd374cbeafc76dc07396138e2025-08-20T03:10:39ZengWileyPhysiological Reports2051-817X2025-02-01133n/an/a10.14814/phy2.70210Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot studyJenna L. Taylor0Aidan K. Downs1Crystal L. Danner2J. Hunter Downs III3Josh Donkor4Jessica I. Johnston5Douglas Rozendaal6Peter L. Larsen7Bruce D. Johnson8Douglas T. Summerfield9Human Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USAHuman Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USAMercyOne North Iowa Medical Center Mason City Iowa USAHuman Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USAHuman Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USAHuman Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USAPlaneLease LCC Mason City Iowa USAMercyOne North Iowa Medical Center Mason City Iowa USAHuman Integrative and Environmental Physiology Laboratory, Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USAMercyOne North Iowa Medical Center Mason City Iowa USAAbstract Aim We investigated whether a commercial bi‐level positive airway pressure (BPAP) device, would improve peripheral oxygen saturation (SpO2) during recreational aviation up to 12,500 feet without supplemental oxygen. Ten adults with recreational flight experience (age:47 ± 14; female = 5) completed a standardized flight profile in an unpressurised aircraft, involving randomized crossover design at 8,000 feet and 12,500 feet with BPAP or control. SpO2, middle cerebral artery velocity (MCAv), heart rate (HR), respiratory rate (RR), and relative tidal volume (TV) index were measured continuously. Psychomotor vigilance test (3‐min) assessed reaction time halfway through taxi and altitude stages. Altitude significantly (p < 0.05) decreased mean SpO2, MCAv, and RR, and increased TV index and HR. There was no effect of altitude (p > 0.05) on reaction time. BPAP increased mean SpO2 at 8,000 feet [Control: 92 ± 1%; BPAP: 94 ± 2%; mean difference (MD) = 2 ± 2%; p = 0.002] and 12,500 feet [Control: 86 ± 4%; BPAP: 89 ± 4%; MD = 2 ± 3%; p = 0.013]. BPAP lowered MCAv at 8,000 feet [Control: 53 ± 10 cm/s; BPAP: 50 ± 9 cm/s; MD = ‐3 ± 2 cm/s; p = 0.001] and 12,500 feet [Control: 52 ± 10 cm/s; BPAP: 50 ± 8 cm/s; MD = ‐2 ± 3 cm/s; p = 0.041]. BPAP increased TV index at 8,000 feet (Control: 6.6 ± 1.3; BPAP:8.1 ± 1.8; MD = 1.9 ± 0.8; p < 0.001) but not 12,500 feet, without effect on RR or reaction time. This study provides preliminary results that BPAP may improve mean SpO2 for recreational aviators up to 12,500 feet without supplemental oxygen.https://doi.org/10.14814/phy2.70210cerebral blood flowreaction timerespiratory ratetidal volume
spellingShingle Jenna L. Taylor
Aidan K. Downs
Crystal L. Danner
J. Hunter Downs III
Josh Donkor
Jessica I. Johnston
Douglas Rozendaal
Peter L. Larsen
Bruce D. Johnson
Douglas T. Summerfield
Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study
Physiological Reports
cerebral blood flow
reaction time
respiratory rate
tidal volume
title Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study
title_full Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study
title_fullStr Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study
title_full_unstemmed Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study
title_short Positive pressure ventilation improves oxygen saturation at altitude during recreational aviation: A pilot study
title_sort positive pressure ventilation improves oxygen saturation at altitude during recreational aviation a pilot study
topic cerebral blood flow
reaction time
respiratory rate
tidal volume
url https://doi.org/10.14814/phy2.70210
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