When traveling long distances, beware of "economy class syndrome"!

Author: Kan Shifeng, deputy chief physician, First People's Hospital, Shanghai Jiao Tong University School of Medicine

Pan Hengde Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

Reviewer: Feng Rui, Chief Physician, First People's Hospital, Shanghai Jiao Tong University School of Medicine

With the accelerated pace of life and the increasing need for communication and interaction between people, many people need to travel long distances for work and study, and it is common to cross geographical boundaries and take planes, trains or buses for several hours. During long flights, have you ever experienced swelling, soreness, and stiff joints in your lower limbs? Have you ever experienced comfortable shoes that suddenly became tight? Or even worse, have you experienced chest tightness, shortness of breath, difficulty breathing, or even life-threatening? This may be due to economy class syndrome.

What is Economy Class Syndrome?

During long-distance travel, when people take economy class airplanes, hard seats on trains, and long-distance buses, due to the small space for movement and inconvenience in movement, they need to sit still in narrow seats for a long time, and their limbs cannot move freely. The squeezing effect of muscle contraction on the blood vessels in the lower limbs is weakened, and the venous blood returns slowly, causing blood to accumulate in the venous system of the lower limbs and swelling of the lower limbs. In addition, due to the inconvenience of going to the toilet during travel, passengers usually intentionally reduce the amount of water they drink, which leads to blood concentration and increased viscosity, thereby significantly increasing the risk of lower limb venous thrombosis. If a thrombosis is formed, when the passenger resumes activities, such as standing or walking, the thrombus may fall off and return to the heart with the blood, and then enter the pulmonary artery, causing acute pulmonary embolism and endangering life. Most of these patients are passengers in the narrow economy class, hence the name - "economy class syndrome." The term first appeared in 2000, when a 28-year-old British woman suddenly fell to the ground when she got off the plane at London Heathrow International Airport after a 20-hour economy class flight. She was sent to the hospital and died. Because of the special symptoms, the media called it "economy class syndrome". Similar cases have been reported all over the world. It is worth noting that it is not only long-distance travel that can induce economy class syndrome, but also long-term sitting at a desk, playing computer games, and playing mahjong can also cause such incidents.

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Who is at high risk of economy class syndrome?

The high-risk groups for economy class syndrome include: ① patients with certain chronic diseases, such as tumors, heart failure, diabetes, hyperlipidemia, nephrotic syndrome, etc.; ② patients with a history of thrombosis or vascular diseases, such as atherosclerosis, varicose veins, heart valve disease, abnormal coagulation function, etc.; ③ special groups, such as patients who have recently undergone surgery, pregnant women, long-term oral contraceptive users, fever patients, elderly people, smokers, etc. These groups should be highly vigilant about economy class syndrome when traveling long distances!

How to avoid economy class syndrome?

Economy class syndrome is very harmful, so what should we pay attention to when traveling long distances to avoid its occurrence?

Before a long trip: Do not eat food that is too salty or too greasy to prevent more water from accumulating in the body and becoming difficult to excrete; Wear comfortable shoes and loose clothes to avoid affecting blood circulation; Avoid crossing your legs for long periods of time, which will compress the blood vessels in your lower limbs; It is recommended that high-risk groups wear compression stockings, and medical graded decompression stockings (pressure value 15-30 mmHg) are recommended.

During long-distance travel: drink plenty of water, preferably 200 ml of water per hour, to reduce blood viscosity, but avoid drinking alcohol, drinking large amounts of coffee, etc. To prevent economy class syndrome, it is more important to do physical activities during long-distance travel. Studies have found that sitting still for more than 4 hours may lead to thrombosis. Therefore, it is strongly recommended to do physical activities every 1 to 2 hours during long-distance travel. The following actions are recommended.

(1) Tiptoe

Sit on a chair, bend both knees, put your heels on the ground, and hook both toes upwards, hold for 3 to 5 seconds, slowly lower them, and repeat 10 times.

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(2) Lift your heels

Sit on a chair with your legs perpendicular to the ground. Lift your heels with force and place your toes on the ground. Hold for 3 to 5 seconds, then slowly lower them. Repeat 10 times.

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(3) Thigh stretch

Sit on a chair, straighten your lower limbs, press your knees down hard, tighten your thighs, hold for 3 to 5 seconds, relax, and repeat 10 times.

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(4) Ankle rotation

Sit on a chair, lift one lower limb slightly off the ground, rotate the ankle joint, and make circles with the toes. Make circles clockwise 10 times and counterclockwise 10 times, then do the same with the other foot.

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The above movements can effectively stimulate the contraction of lower limb muscles, play the role of muscle pump, squeeze the blood vessels of the lower limbs, accelerate blood flow, and avoid blood stasis and thrombosis. During long-distance travel, in addition to the above exercise movements, if space permits, it is recommended that you get up and move around frequently, such as doing squats, muscle stretching, gymnastics, etc., which can effectively prevent the occurrence of economy class syndrome.

Finally, I would like to remind everyone that if you experience swelling of the lower limbs, chest tightness, chest pain, difficulty breathing, pale complexion, tendency to fainting, etc. during your trip, you should promptly inform the staff, seek help, and go to the hospital as soon as possible to avoid serious incidents.