Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New DVT guidelines: No evidence to support 'economy class syndrome'

07.02.2012
Oral contraceptives, sitting in a window seat, advanced age, and pregnancy increase DVT risk in long-distance travelers

New evidence-based guidelines from the American College of Chest Physicians (ACCP) address the many risk factors for developing a deep vein thrombosis (DVT), or blood clot, as the result of long-distance travel.

These risk factors include the use of oral contraceptives, sitting in a window seat, advanced age, and pregnancy. The Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, published in the February issue of the journal CHEST, also suggest there is no definitive evidence to support that traveling in economy class can lead to the development of a DVT, therefore, dispelling the myth of the so-called "economy class syndrome."

"Traveling in economy class does not increase your risk for developing a blood clot, even during long-distance travel; however, remaining immobile for long periods of time will," said guideline co-author Mark Crowther, MD, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. "Long-distance travelers sitting in a window seat tend to have limited mobility, which increases their risk for DVT. This risk increases as other factors are present." DVT is a serious condition that can lead to a potentially fatal blockage in the lung known as a pulmonary embolism (PE).

DVT/PE RISK FACTORS FOR LONG-DISTANCE TRAVEL

Although developing a DVT/PE as the result of long-distance travel is unlikely in most cases, the guidelines note that for long-distance flights, the following factors may increase your risk of developing a DVT/PE and related complications:

Previous DVT/PE or known thrombophilic disorder
Malignancy
Recent surgery or trauma
Immobility
Advanced age
Estrogen use, including oral contraceptives
Pregnancy
Sitting in a window seat
Obesity
Conversely, the guidelines suggest there is no definitive evidence to support that dehydration, alcohol intake, or sitting in economy class (compared with sitting in business class) increases your risk for developing a DVT/PE resulting from long-distance flights.

RECOMMENDATIONS FOR DVT/PE PREVENTION IN LONG-DISTANCE TRAVELERS

For travelers on flights of 6 hours or more who have an increased risk for DVT/PE, the ACCP recommends frequent ambulation, calf muscle stretching, sitting in an aisle seat if possible, or the use of below-knee graduated compression stockings (GCS). For long-distance travelers who are not at increased risk for DVT/PE, the guidelines suggest against the use of GCS. In addition, the guidelines suggest against the use of aspirin or anticoagulant therapy to prevent DVT/PE in long-distance travelers. For travelers who are considered to be at particularly high risk for DVT/PE, the use of antithrombotic agents should be considered on an individual basis because the adverse effects may outweigh the benefits.

"Symptomatic DVT/PE is rare in passengers who have returned from long flights; however the association between air travel and DVT/PE is strongest for flights longer than 8 to 10 hours," said Dr. Crowther. "Most passengers who do develop a DVT/PE after long-distance travel have one or more risk factors."

PATIENT-FOCUSED ANTITHROMBOTIC GUIDELINES

In addition to long-distance travel, the ACCP guidelines include more than 600 recommendations for the prevention, diagnosis, and treatment of thrombosis, addressing a comprehensive list of clinical conditions. These clinical conditions include medical, surgery, orthopedic surgery, atrial fibrillation, stroke, cardiovascular disease, pregnancy, and neonates and children, among others. Key advances in this edition of the guidelines include a stronger focus on risk stratification of patients, which suggests clinicians should consider a patient's risk for DVT/PE before administering or prescribing a prevention therapy.

"There has been a significant push in health care to administer DVT prevention for every patient, regardless of risk. As a result, many patients are receiving unnecessary therapies that provide little benefit and could have adverse effects," said Guidelines Panel Chair Gordon Guyatt, MD, FCCP. "The decision to administer DVT prevention therapy should be based on the patients' risk and the benefits of prevention or treatment." The new guidelines also take a more patient-focused approach by considering patient values and preferences regarding antithrombotic therapy and prevention.

The guidelines are endorsed by the following medical associations: the American Association for Clinical Chemistry, American College of Clinical Pharmacy, American Society of Health-System Pharmacists, American Society of Hematology, International Society of Thrombosis and Hemostasis, and the American College of Obstetrics and Gynecology (pregnancy article only).

For more information about the guidelines and accompanying clinician resources, visit http://www.chestnet.org and follow #AT9 on Twitter. Patient resources related to the guidelines are available through OneBreath, an initiative of The CHEST Foundation, the philanthropic arm of the ACCP.

ABOUT THE AMERICAN COLLEGE OF CHEST PHYSICIANS

The ACCP represents 18,400 members who provide patient care in the areas of pulmonary, critical care, and sleep medicine in the United States and more than 100 countries throughout the world. The mission of the ACCP is to promote the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. CHEST is the official peer-reviewed publication of the ACCP. More than 30,000 readers worldwide turn to CHEST in print and 400,000 people view CHEST online each month for the latest in chest-related medicine. For more information about the ACCP, visit www.chestnet.org or follow the ACCP via social media at http://www.facebook.com/accpchest and www.twitter.com @accpchest.

Jennifer Stawarz | EurekAlert!
Further information:
http://www.chestnet.org

More articles from Health and Medicine:

nachricht Plasmonic biosensors enable development of new easy-to-use health tests
14.12.2017 | Aalto University

nachricht ASU scientists develop new, rapid pipeline for antimicrobials
14.12.2017 | Arizona State University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Plasmonic biosensors enable development of new easy-to-use health tests

14.12.2017 | Health and Medicine

New type of smart windows use liquid to switch from clear to reflective

14.12.2017 | Physics and Astronomy

BigH1 -- The key histone for male fertility

14.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>