Air travel and the risk of thromboembolism |
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Authors: | Israel Gavish Benjamin Brenner |
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Institution: | (1) Thrombosis and Haemostasis Unit, Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, POB 9602, Haifa, 31096, Israel;(2) Haematology Unit, Ha’Emek Medical Center, Afula, Israel;(3) Rapapport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel |
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Abstract: | Almost two billion people use commercial aircraft annually. Long-haul flights are taken by over 300 million people. A serious
complication of long-distance travel (or prolonged time of flight) is thromboembolism. The real incidence of the problem is
difficult to evaluate since there is no consensus about the diagnostic tests or limitation of time after landing connected
to the VTE complication. A direct relation between VTE incidence and long-distance flights has been documented. The risk for
DVT is 3–12% in a long-haul flight. The pathophysiologic changes that increase VTE risk at flight are stasis (sitting in crowded
condition), hypoxia in the airplane cabin, and dehydration. Individual risk factors for air travel-related VTE include age
over 40 years, gender (female), women who use oral contraceptives, varicose veins in lower limbs, obesity and genetic thrombophilia.
Prevention measures include environmental protection such as keeping the pressure inside the airplane cabinet in hypobaric
condition, avoiding dehydration and prolonged sitting. For individuals at increased risk, venous blood stasis can be reduced
by wearing elastic stockings and prophylactic use of low-molecular-weight heparin. |
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