[Economy class syndrome: fiction or fact?]

Several reports about the occurrence of deep vein thrombosis and pulmonary embolism following long-distance flights have led to the term "economy class syndrome". The underlying hypothesis was that a long term immobilisation in narrow economy class chairs of modern jet aircraft plays an important role for the development of deep vein thrombosis. Studies in healthy volunteers during several simulated long distance flights and during an actual long-distance flight confirmed the swelling of the lower legs complained by many long distance passengers, however, failed to reveal relevant changes of hemorheological or hemostaseological parameters. From these investigations no increased risk for thromboembolic diseases during long distance flights for healthy volunteers could be derived. Since this may be completely different for patients with risk factors for thromboembolic diseases prophylactic measures (compression stockings, anticoagulation) might be necessary.