Saturday, March 11, 2006

Economy Class Syndrome

We are all aware that prolonged immobilisation causes stasis in circulation, especially in the veins of the lower limbs. Stasis, in turn, is a major factor in the formation of clots. This was well documented by Rudolph Virchow about one and half centuries ago. The classical Virchow's triad consisted of hemeostasis, venous injury and hypercoagulability of blood.

A recent study by Prof Rosedaal of Leiden, published in the Lancet shows that stasis may not be the only factor causing blood clots in the lower limbs. There seemed to be some genetic predisposition. There could also be other conditions in the aircraft cabin, like low oxygen concentration in crowded cabins. Perhaps there may also be some venous wall injury (maybe casual, unnoticed by the passenger) . This may explain why the circumstances surrounding the "economy class syndrome" is so mixed, except for immobilisation of more then 8 hours. Perhaps wise old Virchow 150years ago, can still teach us a little about surviving modern day air travel.

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