Paul T Kelly's research while affiliated with Canterbury District Health Board and other places

Publications (16)

Article
Aim: Obtain an overview of the current sleep habits and sleep hygiene practices in a group of intermediate-aged students, and establish whether these students achieve adequate sleep according to the New Zealand education and health guidelines. Methods: A standardised sleep health questionnaire and seven-day sleep diary were completed by 163 part...
Article
Full-text available
Sleep disorders: MORE ASSESSMENTS, SHORTER WAITS WITH COMMUNITY SLEEP SERVICE: A community-based service for common sleep disorders can provide rapid and easily accessed sleep assessment and treatment. A team led by Michael Hlavac and Michael Epton from Christchurch Hospital describe the creation of a sleep assessment service within the Canterbury...
Article
To investigate grey matter volume and concentration and cerebral perfusion in people with untreated obstructive sleep apnea (OSA) while awake. Voxel-based morphometry to quantify grey matter concentration and volume. Arterial spin labeling perfusion imaging to quantify cerebral perfusion. Lying supine in a 3-T magnetic resonance imaging scanner in...
Article
Background and objectiveOxygen is used in many clinical scenarios, however the variable performance of nasal cannulae makes determining the precise fraction of inspired oxygen (FiO2) difficult. We developed a novel method for measurement of the tracheal FiO2 using a catheter placed via bronchoscopy. We investigate the effects of oxygen delivery, re...
Article
Full-text available
Healthy individuals are known to have significantly reduced oxygen saturations at rest when acutely exposed to moderate altitudes, such as during commercial flight. There is a paucity of data on the response of healthy individuals to exercise at these altitudes. The aim of this study was to establish the normal response to exercise during acute, mo...
Article
The aim of this study was to investigate the current policies of Australian and New Zealand airlines on the use of in-flight CPAP by passengers with OSA. A survey was conducted of 53 commercial airlines servicing international routes. Information was obtained from airline call centres and websites. The policies, approval schemes and costs associate...
Article
Altitude exposure will cause moderate to severe hypoxemia in patients with chronic obstructive pulmonary disease (COPD). Supplemental oxygen can be used to attenuate this hypoxemia; however, individual response is variable and difficult to predict. The aim of this study was to assess the efficacy of oxygen supplementation in patients with COPD at a...
Article
Air travel guidelines recommend using baseline arterial oxygen levels and the hypoxic challenge test (HCT) to predict in-flight hypoxaemia and the requirement for in-flight oxygen in patients with lung disease. The purpose of the present study was to (i) quantify the hypoxaemic response to air travel and (ii) identify baseline correlate(s) to predi...
Article
The aim of this study was to investigate the current Australian/New Zealand airline policy on supplemental in-flight oxygen for passengers with lung disease. Fifty-four commercial airlines servicing international routes were surveyed. Information was gathered from airline call centres and web sites. The survey documented individual airline policy o...
Article
Full-text available
Exposure to altitude invariably involves some form of physical activity. There are limited data available to help predict the response to activity at altitude in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate the response to acute altitude exposure at rest and during exercise in patients...
Article
Limited data are available comparing air travel with the hypoxia inhalation test (HIT) in passengers with COPD. The aim of this study was to assess the predictive capability of the HIT to in-flight hypoxemia in passengers with COPD. Thirteen passengers (seven female passengers) with COPD (mean [+/- SD], FEV(1)/FVC ratio, 44 +/- 17%) volunteered for...
Article
Assessing the requirements for in-flight oxygen in passengers with pulmonary limitations can be a challenging task for clinicians. Aeromedical guidelines are available to help identify passengers that may require oxygen in flight. However, little is known about the actual in-flight response to passengers on oxygen. We measured the oxygen response (...
Article
In the low pressure environment of commercial aircraft, hypoxaemia may be common and accentuated in patients with lung or heart disease. Regulations specify a cabin pressure not lower than 750 hPa but it is not known whether this standard is met. This knowledge is important in determining the hazards of commercial flight for patients and the validi...
Article
There is little data available to determine the normal response to normobaric hypoxia inhalation testing (NHIT) and air travel. Quantifying a healthy response may assist in the evaluation of passengers considered at risk for air travel. The aims of this study were: (1) to quantify the degree of desaturation in healthy subjects during a NHIT and air...

Citations

... Of these publications, 5 publications were abstracts and 2 were protocol descriptions. One additional full text article was found after evaluating the abstracts [46][47][48][49][50][51][52][53]. In total, 4 full text articles were relevant and will be discussed separately (Fig. 3). ...
... Over the last two decades, integration of primary and secondary health-care services has led to more health services being provided in the community. [5][6][7][8][9] In 2018, the Planning and Funding section of the Canterbury DHB asked for requests for proposals to deliver selected infusions to patients in the community, instead of patients being required to attend the Medical Day Unit (MDU) at Christchurch Hospital for these. ...
... Previous studies have found lower mean diffusivity values in the temporal lobe display area in OSA patients than in healthy controls, and the pathological mechanisms of this injury may include ischemic and hypoxia-induced processes(Kumar et al. 2012). A decrease in gray matter volume in the bilateral temporal cortex areas was identi ed in structurally relevant studies in OSA patients(Innes et al. 2015;Joo et al. 2010;Yaouhi et al. 2009). Another study found that after 6 weeks of CPAP treatment, mean diffusivity values in the temporal lobe were lowered and cerebral blood ow increased, suggesting that CPAP treatment can promote the repair and recovery of brain injury in OSA patients(Maresky et al. 2019). ...
... We also collected: demographic data, reason for ICU admission, Simplified Acute Physiology Score (SAPS II); ventilatory settings (in patients with a simple nasal cannula, FiO 2 was estimated as follows: oxygen flow (l/ min) × 3 + 21) [15]; neurological status data: Richmond Agitation Sedation Scale (RASS) if subjects were sedated or Glasgow Coma Scale (GCS) if not, and hemodynamic data. Finally, we collected information on the use of commonly used drugs that might affect vasomotion (remifentanil, sufentanil, propofol, midazolam, norepinephrine, milrinone, urapidil and nicardipine). ...
... Известно, что увеличение высоты над уровнем моря приводит к снижению парциального давления кислорода во вдыхаемом воздухе и артериальной крови, а также уровня сатурации крови [16,29]. При этом даже при подъеме на высоту 2000 м сатурация крови у здоровых лиц снижается, в среднем, до 96%, а при занятиях физическими упражнениями -до 89%, что значимо ниже, чем на уровне моря (~99%) [30]. Дальнейший подъем до 2800 м снижает сатурацию крови, в среднем, до 91% [31]. ...
... 23 Air transport and noninvasive ventilation neonates (most with neonatal respiratory distress syndrome) during air transport. 11 Experience with CPAP for adults with obstructive sleep apnea during routine commercial airline operation is growing: guidelines governing in-flight use are common, 24 and some commercial providers offer explicit guidance on their websites. 25 Consideration regarding the use of NIV during air transports should focus on the limitations in space, equipment and personnel associated with the use of aircraft, as well as altitude physiology: gas in a closed space will expand in volume with altitude, as oxygen tension, as well as humidity and temperature, decline. ...
... Walking test assessments in patients with COPD (2,086 m; New Zealand) have demonstrated that sea-level oxygenation status and diffusing capacity correlated with resting oxygenation status and exercise-induced desaturation at altitude (63). In a related study, supplemental O 2 partially reversed resting desaturation at altitude; those patients with diffusion impairments had a greater degree of desaturation but a greater benefit from supplemental O 2 (61). One might speculate that CPET indices of ventilatory efficiency, such as the slope of the ventilation-_ VCO 2 relationship, the ventilatory equivalent for CO 2 (ventilation/ _ VCO 2 ) at the lactate threshold or the minimum ventilatory equivalent for CO 2 (1,13) at sea level might confer a degree of predictive power for exercise-induced desaturation at high altitude in diseases such as COPD that are characterized by _ V/ _ Q maldistribution. ...
... Finally, Kelly et al. studied 14 ILD patients during air travel and found that sea level SpO2 was predictive of in-flight SpO2 -mean 95% and 85%, respectively-. Seven patients were eligible for in-flight oxygen according to HCT results, out of whom 3 reported dyspnea while in the aircraft 15 . ...
... Niektóre linie pobierają opłatę za możliwość korzystania z tlenu. Posiadacze przenośnych koncentratorów tlenu mogą z nich korzystać podczas lotu [128]. ...
... [1] COPD-patients are at higher risk to experience altitude related adverse health effects (ARAHE), but only few studies in COPD patients exposed to high altitude report about potential implications on health and preventive strategies. [2][3][4][5][6][7][8][9][10][11] Evidence for an altitude-associated increase in mortality in COPD underscores the need of research in this field. [12,13] COPD is the most common chronic respiratory disease worldwide [14], with a reported prevalence of around15% of the general population. ...