{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:22:07Z","timestamp":1790018527603,"version":"4.0.1"},"reference-count":21,"publisher":"Aerospace Medical Association","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["aerosp med hum perform"],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:p><jats:bold>INTRODUCTION:<\/jats:bold> Physiological episodes are an issue in military aviation. Some non-pressure-related in-flight symptoms are proved to be due to hyperventilation rather than hypoxia. The aim of this study was to validate a new training method provoking hyperventilation during normobaric\n hypoxia (NH) training in an F\/A-18 Hornet simulator.<jats:bold>METHODS:<\/jats:bold> In a double-blind setting, 26 fighter pilots from the Finnish Air Force performed 2 setups in a WTSAT simulator in randomized order with full flight gear. Without the pilot's knowledge, 6% O<jats:sub>2<\/jats:sub> in nitrogen or\n 6% O<jats:sub>2<\/jats:sub> + 4% CO<jats:sub>2<\/jats:sub> in nitrogen was turned on. Ventilation (VE) was measured before, during, and after hypoxia. S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> and ECG were monitored and symptoms documented. The subjects performed a tactical identification flight until they recognized symptoms\n of hypoxia. Thereafter, they performed hypoxia emergency procedures with 100% O<jats:sub>2<\/jats:sub> and returned to the base with a GPS malfunction and executed an instrument landing system (ILS) approach with the waterline HUD mode evaluated by the flight instructor on a scale of 1 to 5.<jats:bold>RESULTS:<\/jats:bold>\n Ventilation increased during normobaric hypoxia (NH) from 12 L \u00b7 min<jats:sup>\u22121<\/jats:sup> to 19 L \u00b7 min<jats:sup>\u22121<\/jats:sup> at S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub> 75% with 6% O<jats:sub>2<\/jats:sub>, and from 12 L \u00b7 min<jats:sup>\u22121<\/jats:sup> to 26 L \u00b7 min<jats:sup>\u22121<\/jats:sup> at S<jats:sub>p<\/jats:sub>o<jats:sub>2<\/jats:sub>\n 77% with 6% O<jats:sub>2<\/jats:sub> + 4% CO<jats:sub>2<\/jats:sub>. ILS flight performance was similar 10 min after combined hyperventilation and hypoxia (3.1 with 6% O<jats:sub>2<\/jats:sub> + 4% CO<jats:sub>2<\/jats:sub> and 3.2 with 6% O<jats:sub>2<\/jats:sub>). No adverse effects were reported during the 24-h follow-up.<jats:bold>DISCUSSION:<\/jats:bold>\n Hyperventilation-provoking normobaric hypoxia training is a new and well-tolerated method to meet NATO Standardization Agreement hypoxia training requirements.<jats:bold>Leinonen AM, Varis NO, Kokki HJ, Leino TK. <jats:italic>A new method for combined hyperventilation and hypoxia training in a tactical\n fighter simulator<\/jats:italic>. Aerosp Med Hum Perform. 2022; 93(9):681\u2013687.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6027.2022","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T04:38:44Z","timestamp":1665635924000},"page":"681-687","source":"Crossref","is-referenced-by-count":5,"title":["A New Method for Combined Hyperventilation and Hypoxia Training in a Tactical Fighter Simulator"],"prefix":"10.3357","volume":"93","author":[{"given":"Antti M.","family":"Leinonen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikke O.","family":"Varis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannu J.","family":"Kokki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomo K.","family":"Leino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"4","key":"B1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3357\/AMHP.5719.2021","article-title":"Hypoxia-like events in UK Typhoon aircraft from 2008 to 2017","volume":"92","year":"2021","journal-title":"Aerosp Med Hum Perform."},{"key":"B2","volume-title":"A comparison of acute hypoxia induced by low concentrations of oxygen at ground level, 10,000 feet and by air at 25,000 feet. 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