The role of hypoxia and platelets in air travel-related venous thromboembolism

被引:27
作者
Bradford, A. [1 ]
机构
[1] Royal Coll Surgeons Ireland, Dept Physiol, Dublin 2, Ireland
关键词
venous thromboembolism; deep vein thrombosis; pulmonary embolism; platelet activation; platelet aggregation; hypoxia; thrombocytosis; thrombocytopaenia;
D O I
10.2174/138161207781662966
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Although somewhat controversial, there is good evidence that long-distance travel in general is a risk factor for venous thromboembolism, even in the absence of other risk factors. This is probably due to effects consequent to prolonged sitting but air travel in particular may be associated with risk factors other than this. One likely factor is hypoxia caused by the low ambient pressure of aircraft cabins. There is an association between venous thromboembolism and the hypoxia of altitude, chronic respiratory disease, neonatal hypoxia, sleep apnoea and experimentally-induced hypoxia. Platelet number and/or function are altered in all of these circumstances. Platelet aggregation is pivotal to venous thromboembolism and hypoxia alters platelet number and function. The early-onset thrombocylosis caused by hypoxia may be due to increased release of platelets from megakaryocytes and the late-onset thrombocytopaenia may be due to decreased platelet production and/or stem cell competition between erythrocytes and megakaryocytes. Hypoxia-induced platelet activation and aggregation may be due to increased circulating catecholamine levels but it is not known whether hypoxia can affect platelets directly. There is a need for further studies on the possible involvement of hypoxia-induced changes in platelet number and function in air travel-related venous thromboembolism.
引用
收藏
页码:2668 / 2672
页数:5
相关论文
共 111 条
[1]   Direct thrombin inhibitors for the prevention of venous thromboembolism after major orthopaedic surgery [J].
Agnelli, G ;
Sonaglia, F ;
Becattini, C .
CURRENT PHARMACEUTICAL DESIGN, 2005, 11 (30) :3885-3891
[2]  
AKAHORI M, 1995, HAEMATOLOGIA, V26, P191
[3]   OPERATION EVEREST .2. COAGULATION SYSTEM DURING PROLONGED DECOMPRESSION TO 282 TORR [J].
ANDREW, M ;
OBRODOVICH, H ;
SUTTON, J .
JOURNAL OF APPLIED PHYSIOLOGY, 1987, 63 (03) :1262-1267
[4]   Obstructive sleep apnea and venous thromboembolism [J].
Arnulf, I ;
Merino-Andreu, M ;
Perrier, A ;
Birolleau, S ;
Similowski, T ;
Derenne, JP .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 287 (20) :2655-2656
[5]   Long-haul flights and deep vein thrombosis: a significant risk only when additional factors are also present [J].
Arya, R ;
Barnes, JA ;
Hossain, U ;
Patel, RK ;
Cohen, AT .
BRITISH JOURNAL OF HAEMATOLOGY, 2002, 116 (03) :653-654
[6]   EFFECT OF HYPOXIA ON PLATELET COUNT [J].
ATKINS, P ;
LEMPKE, RE .
BRITISH JOURNAL OF SURGERY, 1970, 57 (08) :583-&
[7]  
*AV SPAC ENV MED, 2003, MED GUID AIRL TRAV, V74
[8]  
Backman H, 2000, Optometry, V71, P653
[9]  
Bagshaw M, 2001, AVIAT SPACE ENVIR MD, V72, P848
[10]  
BAREL AO, 1995, SKIN PHARMACOL, V8, P186