Venous Thromboembolism from Air Travel: The LONFLIT Studies

Belcaro, Gianni; Cesarone, M. R.; Dugall, Mark; Vinciguerra, G.; Ledda, Andrea; Errichi, B. M.

doi:10.1007/4-431-27121-x_10

Cited by 59 publications

(130 citation statements)

References 15 publications

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“…Compression stockings have been shown to decrease the incidence of DVT by almost nineteenfold in extended flights in high-risk subjects and all DVTs were observed in subjects sitting in a window or central seats [4]. In-flight stockings providing 20-30 mmHg graduated pressure have been shown to prevent edema and swelling [21].…”

Section: Discussionmentioning

confidence: 99%

“…When correctly fitted, they significantly reduce vessel diameter and are associated with an expected increase in linear velocity of venous outflow, preventing stasis and venous distension by enhancing the emptying of valvular cusps [22][23][24]. Recommended DVT preventative measures for high-risk long-distance travelers include correctly fitted below-knee GCS (15-30 mmHg graduated pressure) or prophylaxis with single dose of LMWH prior to departure [4,11,13]. The use of aspirin is not recommended [13].…”

Section: Discussionmentioning

confidence: 99%

“…In 1954 Homans reported a case of DVT that occurred in a physician after a 14-h flight, thereby associating VTE and longterm immobility from confined seating with air travel [2]. Studies have shown that asymptomatic lower limb DVT may arise in up to 10% of long-distance travelers depending on patient baseline risk of VTE [3,4], and that 4-20% of patients presenting with VTE have traveled within a few weeks prior to the event [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Sitting for up to 1 h decreases venous return from the legs and leads to local hemoconcentration [9], with 12 h of air travel resulting in swelling and fluid retention [10]. Interestingly, 85-100% of VTE cases have been found to occur in passengers in non-aisle seats [4,11]. Factors such as chair position and, in the case of air travel, cabin-related factors such as low humidity, reduced air pressure and relative hypoxia, may be important [12].…”

Section: Introductionmentioning

confidence: 99%

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Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Hitos

Cannon²,

Cannon³

et al. 2007

Journal of Thrombosis and Haemostasis

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To cite this article: Hitos K, Cannon M, Cannon S, Garth S, Fletcher JP. Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel-related deep vein thrombosis. J Thromb Haemost 2007; 5: 1890-5.Summary. Background: Venous stasis is an important contributing factor in the development of travel-related deep vein thrombosis. This study examined factors affecting popliteal venous blood flow in order to determine the most effective exercise regimen to prevent venous stasis. Methods: Twentyone healthy subjects were randomly assigned to various activities over a 9-week period. Subjects remained seated throughout the investigation and 3660 duplex ultrasound examinations were performed by a single examiner using a SonoSite 180 Plus handheld ultrasound. Baseline popliteal vein blood flow velocity, cross-sectional area and volume flow in subjects sitting motionless were assessed in the first 3 weeks.The remaining 6 weeks involved subjects performing airline-recommended activities, foot exercises, foot exercises against moderate resistance and foot exercises against increased resistance in order to determine the most beneficial method for enhancing popliteal venous flow. Sitting with feet not touching the floor and the effect of sleeping were also assessed. Results: The median age of the subjects was 22 years (range: 18-25.5 years), height 171 cm (162.5-180.5 cm) and body mass index 25.3 kg m -2 (23.2-26.3 kg m -2). Blood volume flow in the popliteal vein was reduced by almost 40% with immobility of seated subjects and by almost 2-fold when sitting motionless with feet not touching the floor. Foot exercises against increased resistance positively enhanced volume flow (P < 0.0001). Conclusion: Leg exercise regimens enhanced popliteal venous flow during prolonged immobility of seated subjects, reinforcing the importance of regular leg movement to prevent venous stasis during prolonged sitting, such as in longdistance travel.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Hitos

Cannon²,

Cannon³

et al. 2007

Journal of Thrombosis and Haemostasis

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“…In 1954 HOMANS [2] reported that VTE may occur after prolonged sitting in a number of other situations, such as in aeroplane flights, car trips and even attendance at the theatre. More recently interest has focused on VTE associated with prolonged air travel, due in part to the reported frequency of VTE in up to 10% of high-risk travellers and the trend of increasing air travel with w1 billion passengers flying every year [3,4]. Another sedentary life-style pattern that has developed over recent decades is the extensive use of computers in relation to work, recreation and personal communication.…”

mentioning

confidence: 99%

eThrombosis: the 21st Century variant of venous thromboembolism associated with immobility

Beasley¹,

Raymond²,

Hill³

et al. 2003

Eur Respir J

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The association between immobility with prolonged sitting and venous thromboembolism has been recognised forw60 yrs, most recently with long distance air travel. The case of a 32-yr-old male, in whom immobility associated with sitting for long periods at a computer represented the major provoking risk factor for his lifethreatening venous thromboembolism, is presented. The authors propose the term "eThrombosis" to describe this 21st Century variant of venous thromboembolism associated with immobility from prolonged sitting. In view of the widespread use of computers in relation to work, recreation and personal communication, the potential burden of eThrombosis may be considerable. The link between prolonged sitting and venous thromboembolism (VTE) was first recognised during the London blitz in World War II when SIMPSON [1] reported fatal pulmonary embolism occurring in persons who had sat for prolonged periods in deck chairs while taking refuge in air-raid shelters. In 1954 HOMANS [2] reported that VTE may occur after prolonged sitting in a number of other situations, such as in aeroplane flights, car trips and even attendance at the theatre. More recently interest has focused on VTE associated with prolonged air travel, due in part to the reported frequency of VTE in up to 10% of high-risk travellers and the trend of increasing air travel with w1 billion passengers flying every year [3,4]. Another sedentary life-style pattern that has developed over recent decades is the extensive use of computers in relation to work, recreation and personal communication. In this report the authors present a case in which immobility associated with sitting for long periods at a computer represented the major provoking risk factor for a life-threatening VTE. Case reportThe authors report the case of a 32-yr-old male who gave a history of a swollen painful calf 6 weeks previously, which resolved after 10 days. During the 4 weeks prior to presentation he noticed increasing breathlessness on exertion, to the extent that he was breathless during minimal activity. On the day of the presentation he experienced a syncopal episode in which he lost consciousness. He denied haemoptysis or pleuritic pain; there was no family history of VTE. On examination he was afebrile, heart rate 120 beats?min -1 , blood pressure 130 over 95, respiratory rate 20 breaths?min -1 , jugular venous pressure not raised, chest clear on auscultation and prominent facial contusions were noted.The electrocardiogram showed sinus tachycardia and severe right heart strain ( fig. 1); arterial blood gases on room air showed pH 7.45, carbon dioxide arterial tension 3.86 kPa (29 mmHg), arterial oxygen tension 7.45 kPa (56 mmHg), bicarbonate 19 mmol?L -1 , oxygen saturation 93% and the chest radiograph showed prominence of the hila and airspace consolidation of the superior segment of the left lower lobe. A provisional diagnosis of pulmonary embolism was made and this was confirmed by pulmonary angiography with helical computer tomography angiogram, which sho...

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Incidence of Air Travel–Related Pulmonary Embolism at the Madrid-Barajas Airport

Pérez-Rodríguez¹,

Jiménez²,

Díaz³

et al. 2003

Arch Intern Med

133

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Venous Thromboembolism from Air Travel: The LONFLIT Studies

Cited by 59 publications

References 15 publications

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel‐related deep vein thrombosis

eThrombosis: the 21st Century variant of venous thromboembolism associated with immobility

Incidence of Air Travel–Related Pulmonary Embolism at the Madrid-Barajas Airport

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