- Economy class syndrome
Economy class syndrome is the occurrence of
deep vein thrombosis in air travelers.cite journal |author=Philbrick JT, Shumate R, Siadaty MS, Becker DM |title=Air travel and venous thromboembolism: a systematic review |journal=Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine |volume=22 |issue=1 |pages=107–14 |year=2007 |pmid=17351849 |doi=10.1007/s11606-006-0016-0] The term was first coined in the late 1980s [Cruickshank JM, Gorlin R, Jennett B. Air travel and thrombotic episodes: theeconomy class syndrome . "Lancet 1988;2(8609):497-8. PMID 2900413.] when it turned out that people who had traveled long distances by airplane were at an increased risk forthrombosis , especiallydeep venous thrombosis and its main complication,pulmonary embolism . Although all these diseases had been recognised for a long time, the possibility oflitigation against airline companies brought them into the limelight when this "syndrome " was reported.Cause
The mechanism for thrombosis in travellers is probably due to a combination of immobilisation,
dehydration and underlying factors. Additional environmental factors during air travel may possibly include reduced or sudden decrease in atmospheric pressure with consequent desaturation. cite journal |author=Bendz B, Rostrup M, Sevre K, Andersen TO, Sandset PM |title=Association between acute hypobaric hypoxia and activation of coagulation in human beings |journal=Lancet |volume=356 |issue=9242 |pages=1657–8 |year=2000 |pmid=11089830 |doi=10.1016/S0140-6736(00)03165-2] [http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijpm/vol3n2/aero2.xml] Patients with disease that predisposes them for thrombosis, such asantiphospholipid syndrome orcancer , are probably at a much greater risk. The highest risk groups include the elderly, pregnant women, those suffering serious medical conditions such as cancer and those with recent orthopedic surgery (legs or knees).Fact|date=April 2007Prevention
Prevention consists of adequate hydration(drinking, abstaining from
alcoholic beverage s andcaffeine ), moving around and calf muscle exercises. In patients with a known predisposition for thrombosis,aspirin is often prescribed, as this acts as a mildanticoagulant . Severe risk for thrombosis can prompt a physician to prescribe injections withlow molecular weight heparin (LMWH), a form of prophylaxis already in common use in hospital patients.There is clinical evidence to suggest that wearing compression socks whilst traveling also reduces the incidence of thrombosis in people on long haul flights. A randomised study in 2001 compared two sets of long haul airline passengers over the age of 50; one set wore MediUK mediven travel compression hosiery the other did not. The passengers were all scanned and blood tested to check for the incidence of DVT. The results showed that asymptomatic DVT occurred in 10% of the passengers who did not wear compression socks, whilst the group wearing compression had no DVTs. The authors concluded that wearing elastic compression hosiery reduces the incidence of DVT in long haul airline passengers. However it is worth noting that an "asymptomatic" DVT incidence of 10% is much higher than expected (alternatively estimated at less than 0.25% cite journal |author=Hirsh J, O'Donnell MJ |title=Venous thromboembolism after long flights: are airlines to blame? |journal=Lancet |volume=357 |issue=9267 |pages=1461-2 |year=2001 |pmid=11377591] ) and wearing compression stocking was also associated with "symptomatic" superficial thrombophlebitis in 4%. cite journal |author=Scurr JH, Machin SJ, Bailey-King S, Mackie IJ, McDonald S, Smith PD |title=Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial |journal=Lancet |volume=357 |issue=9267 |pages=1485–9 |year=2001 |pmid=11377600|doi=10.1016/S0140-6736(00)04645-6]
ee also
*
Deep vein thrombosis References
External links
* [http://www.mediuk-travel.co.uk/clinical_evidence.html mediUK travel clinical evidence]
* [http://www.varda.org Victims of Air Related DVT Association] (UK)
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