Background
As the number of air travel passengers, especially older passengers, increases, the incidence of medical emergencies during flights is increasing as well. Due to the physical conditions inside a flying aircraft, the likelihood of pneumothorax appears to be increased.
Objective
This article describes the incidence of pneumothorax associated with air travel, identifies populations at risk and analyzes the risk of air travel with or shortly after pneumothorax.
Material and methods
An analysis of the literature and guidelines of air travel associations and medical associations was carried out.
Results
The incidence of air travel-related pneumothorax is extremely low even among patients with pre-existing pulmonary diseases; however, there was an increased incidence of up to 2% per flight among patients with cystic lung disease, specifically Birt-Hogg-Dube syndrome (BHD) and Lymphangioleiomyomatosis (LAM). Recommendations regarding air travel after pneumothorax are heterogeneous and largely based on expert opinions. Air travel is safe 14 days after resolution of a pneumothorax. There is evidence that earlier air travel and even air travel with chronic, stable or a very small pneumothorax do not pose a significant risk.
Discussion
Unfortunately, the volume of empirical data on the subject is limited. While the air travel related incidence of pneumothorax among the general population is marginal, it is much higher among patients suffering from BHD and LAM. Whether this increased incidence is related to air travel or due to the intrinsically high rate of pneumothorax among these patient groups remains to be clarified. Air travel is safe 14 days after resolution of a pneumothorax. Taking into account the patient’s history and the etiology of the pneumothorax, an earlier air travel or even air travel with a chronic, stable or very small residual pneumothorax can be considered.