{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:15:49Z","timestamp":1728360949064},"reference-count":0,"publisher":"Aerospace Medical Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["aerosp med hum perform"],"published-print":{"date-parts":[[2017,5,1]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Blood-injection-injury (B-I-I) phobia is capable of producing inaccurate hypoxic challenge testing results due to anxiety-induced hyperventilation.<jats:bold>CASE REPORT:<\/jats:bold> A 69-yr-old woman with a history of hypersensitivity pneumonitis, restrictive spirometry, exercise\n desaturation requiring supplementary oxygen on mobilizing, reduced DLco, and B-I-I phobia was referred for hypoxic challenge testing (HCT) to assess in-flight oxygen requirements. HCT was performed by breathing a 15% F<jats:sub>I<\/jats:sub>o<jats:sub>2<\/jats:sub> gas mixture, simulating the available oxygen in\n ambient air onboard aircraft pressurized to an equivalent altitude of 8000 ft. S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> fell to a nadir value of 81% during HCT, although it rapidly increased to 89% during the first of two attempts at blood gas sampling. A resultant blood gas sample showed an acceptable\n Po<jats:sub>2<\/jats:sub> outside the criteria for recommending in-flight oxygen and a reduced Pco<jats:sub>2<\/jats:sub>. Entering the nadir S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> value into the Severinghaus equation gives an estimated arterial Po<jats:sub>2<\/jats:sub> of 6 kPa (45 mmHg), which was felt to be more representative of\n resting values during HCT, and in-flight oxygen was recommended.<jats:bold>DISCUSSION:<\/jats:bold> While hyperventilation is an expected response to hypoxia, transient rises in S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> coinciding with threat of injury are likely to be attributable to emotional stress-induced hyperventilation,\n characteristic of B-I-I specific phobia and expected during the anticipation of exteroceptive threat, even in normal subjects. In summary, should excessive hyperventilation be detected during HCT and coincide with transient increases in S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub>, HCT should be repeated using\n S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> only as a guide to the level of hypoxemia, and S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> maintained using supplementary oxygen in accordance with alternative methods described in guidelines.Spurling KJ, McGoldrick VP. <jats:italic>Blood-injection-injury (B-I-I) specific phobia affects the outcome of hypoxic challenge testing<\/jats:italic>. Aerosp Med Hum Perform. 2017; 88(5):503\u2013506.<\/jats:p>","DOI":"10.3357\/amhp.4730.2017","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T12:28:58Z","timestamp":1492518538000},"page":"503-506","source":"Crossref","is-referenced-by-count":1,"title":["Blood-Injection-Injury (B-I-I) Specific Phobia Affects the Outcome of Hypoxic Challenge Testing"],"prefix":"10.3357","volume":"88","author":[{"given":"Kristofer J.","family":"Spurling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica P.","family":"McGoldrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1911","container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/88\/5\/article-p503.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/88\/5\/article-p503.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/88\/5\/article-p503.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:34:06Z","timestamp":1728304446000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/88\/5\/article-p503.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,1]]},"references-count":0,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3357\/amhp.4730.2017","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"type":"print","value":"2375-6314"},{"type":"electronic","value":"2375-6322"}],"subject":[],"published":{"date-parts":[[2017,5,1]]}}}