Lee · Pediatric emergency care 2002 · prospective observational cohort study · n=80

Commercial airline travel decreases oxygen saturation in children.

Cited 67 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective single-group repeated-measures observational cohort study.

PubMed 11973496 · doi:10.1097/00006565-200204000-00004 · record verified 2026-08-30

What was done

Researchers measured pulse oximetry (oxygen saturation and heart rate) in 80 healthy children (43 boys, aged 6 months to 14 years) at sea level before boarding commercial flights between Honolulu, Hawaii, and Taipei, Taiwan. Measurements were repeated at 3 hours and 7 hours of flight across eight flights, alongside cabin pressure, true altitude, and fraction of inspired oxygen.

What was found

Oxygen saturation fell progressively from a sea-level baseline of 98.5% to 95.7% at 3 hours and 94.4% at 7 hours (P < 0.001 for all comparisons). Heart rate increased from 100 beats per minute (BPM) at baseline to 105 BPM at 3 hours and 108 BPM at 7 hours (P < 0.001 vs. baseline, P = 0.014 between 3 and 7 hours). Cabin partial pressure of oxygen dropped from 159 mm Hg at sea level to 126 mm Hg at 3 hours and 124 mm Hg at 7 hours. No acclimation was observed as flight duration increased.

Why it matters

This study quantifies the expected physiological drop in oxygen saturation among healthy children during commercial air travel. While well tolerated in healthy participants, the progressive decline suggests that children with underlying cardiopulmonary disease or anemia may face clinically relevant hypoxemia during long flights.

Limits

There was no non-flying control group evaluated over an equivalent time window. The cohort was restricted to healthy children, leaving the risk profile in children with cardiopulmonary or hematologic disease unmeasured directly. The abstract does not detail passenger activity levels, sleep status during measurements, or long-term post-flight recovery.

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