Extended trips

All passengers who travel for more than four hours are prone to thrombosis due to lack of movement. This is the so-called ‘traveler’s syndrome’

The appearance of DVT and  PE in relation to extended trips by airplane has had a considerable echo in the media in recent years.

This was called ‘economy class syndrome’, with an emphasis on the importance of  lack of space on most commercial flight. This is now referred to as the ‘traveler’s syndrome’, a more precise term. since it can also happen to passengers traveling in business class, as well as to those on long trips by other means of transport.

It is a rare cause of VTE. Although there is a real risk, it is still small. A person who travels long-distance is estimated to have a two to four-fold higher risk of VTE than a person who does not travel at all.

The likelihood of suffering VTE related to traveling is much greater in people with prior risk factors, therefore these people should take preventive measures.

All passengers who do trips of more than four hours, and especially more than 6 to 8 hours, mustfollow a series of recommendations to prevent the appearance of VTD:

• perform exercises periodically such as stretching and contractions of the muscles of the legs
• avoid wearing tight clothing
• avoid being dehydrated, thus drinking adequate amount of water or fruit juices
• avoid drinking alcohol, taking tranquilizers or other substances that promote deep sleep
• to get up and walk on the aisle of the plane or bus periodically
• to frequently change their posture while sitting
• avoid crossing of legs

Travelers with previous risk factors of VTD, should also use proper compression stockings on their legs, which provide pressure at the level of the ankle. These stockings are not prescribed at all for the general public.

The use of anticoagulants in patients with a very high risk seems reasonable, but is not supported by clinical studies and it can be controversial. The efficacy of aspirin for this problem has not been demonstrated either, so its use should be avoided.