From the Guidelines
It is recommended to wait at least 7 days after complete radiological resolution of a pneumothorax before flying on an airplane, as stated in the most recent guidelines 1. This timeframe is based on the British Thoracic Society guideline for pleural disease, which suggests that patients with resolved pneumothorax confirmed radiologically can fly 7 days after the X-ray demonstrates full resolution. The concern with flying too soon relates to Boyle's Law, where any residual air in the pleural space would expand at altitude, potentially causing the pneumothorax to recur or worsen. Some key points to consider include:
- Patients with larger initial pneumothoraces, those who required chest tube placement, or those with underlying lung disease may need longer waiting periods.
- Before flying, patients should obtain clearance from their treating physician who can evaluate their specific situation.
- During the first flight after recovery, it's advisable to stay well-hydrated, avoid alcohol, move periodically during the flight, and be aware of warning signs such as chest pain or increasing shortness of breath that would require immediate medical attention. The previous guidelines from 2003 1 suggested waiting 6 weeks after a definitive surgical procedure or resolution of the pneumothorax, but the more recent guidelines from 2023 1 provide a clearer and more specific recommendation. Other studies, such as the 2010 guidelines for cystic fibrosis pulmonary complications 1, suggest waiting 2 weeks after resolution, but these are not as directly relevant to the general population as the British Thoracic Society guidelines. Overall, the most recent and highest-quality evidence supports waiting at least 7 days after complete radiological resolution before flying.
From the Research
Timing of Air Travel After Pneumothorax
The timing of safe air travel after a pneumothorax (collapsed lung) is a concern due to the risks associated with air pressure changes during flight. According to 2, current guidelines recommend delaying air travel for 1 to 3 weeks after thoracic surgery or resolution of the pneumothorax. However, these guidelines are based on sparse data and may not reflect the most up-to-date evidence.
Recent Studies
More recent studies have challenged these traditional guidelines. For example, 3 found that air travel after tube thoracostomy removal appears safe for both mechanically ventilated and non-ventilated patients after a 72-hour period of observation. Another study 4 suggests that air travel with a known pneumothorax is likely safe and can be undertaken much sooner than current guidelines advise.
Variability in Recommendations
There is variability in recommendations among thoracic surgeons regarding air travel by patients with postoperative pneumothorax and/or pneumomediastinum, as noted in 5. Some surgeons recommend waiting variable periods of time after complete resolution of pneumothorax, while others allow patients to fly with some degree of pneumothorax.
Key Findings
- Air travel after pneumothorax is generally considered safe after a certain period of time, but the exact timing is not well established 2, 6.
- Recent studies suggest that air travel may be safe sooner than traditionally recommended 3, 4.
- More research is needed to develop evidence-based guidelines for air travel after pneumothorax 5, 6.
Considerations for Air Travel
When considering air travel after pneumothorax, it is essential to:
- Consult with a healthcare provider to determine the best course of action.
- Ensure that the pneumothorax has been adequately treated and resolved.
- Follow any recommended guidelines or precautions for air travel after pneumothorax.