Are compression stockings an effective treatment for orthostatic presyncope?

<h4>Background</h4>Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant comorbidity. Many syncopal events occur secondary to excessive venous pooling and capillary filtration in the lower limbs when upright. As such, a common approach to...

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Autores principales:	Clare Louise Protheroe, Anastasia Dikareva, Carlo Menon, Victoria Elizabeth Claydon
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7ff35feb569245f9987364304d2ec286
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spelling	oai:doaj.org-article:7ff35feb569245f9987364304d2ec2862021-11-18T07:31:58ZAre compression stockings an effective treatment for orthostatic presyncope?1932-620310.1371/journal.pone.0028193https://doaj.org/article/7ff35feb569245f9987364304d2ec2862011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22194814/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant comorbidity. Many syncopal events occur secondary to excessive venous pooling and capillary filtration in the lower limbs when upright. As such, a common approach to the management of syncope is the use of compression stockings. However, research confirming their efficacy is lacking. We aimed to investigate the effect of graded calf compression stockings on orthostatic tolerance.<h4>Methodology/principal findings</h4>We evaluated orthostatic tolerance (OT) and haemodynamic control in 15 healthy volunteers wearing graded calf compression stockings compared to two placebo stockings in a randomized, cross-over, double-blind fashion. OT (time to presyncope, min) was determined using combined head-upright tilting and lower body negative pressure applied until presyncope. Throughout testing we continuously monitored beat-to-beat blood pressures, heart rate, stroke volume and cardiac output (finger plethysmography), cerebral and forearm blood flow velocities (Doppler ultrasound) and breath-by-breath end tidal gases. There were no significant differences in OT between compression stocking (26.0±2.3 min) and calf (29.3±2.4 min) or ankle (27.6±3.1 min) placebo conditions. Cardiovascular, cerebral and respiratory responses were similar in all conditions. The efficacy of compression stockings was related to anthropometric parameters, and could be predicted by a model based on the subject's calf circumference and shoe size (r = 0.780, p = 0.004).<h4>Conclusions/significance</h4>These data question the use of calf compression stockings for orthostatic intolerance and highlight the need for individualised therapy accounting for anthropometric variables when considering treatment with compression stockings.Clare Louise ProtheroeAnastasia DikarevaCarlo MenonVictoria Elizabeth ClaydonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 12, p e28193 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Clare Louise Protheroe Anastasia Dikareva Carlo Menon Victoria Elizabeth Claydon Are compression stockings an effective treatment for orthostatic presyncope?
description	<h4>Background</h4>Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant comorbidity. Many syncopal events occur secondary to excessive venous pooling and capillary filtration in the lower limbs when upright. As such, a common approach to the management of syncope is the use of compression stockings. However, research confirming their efficacy is lacking. We aimed to investigate the effect of graded calf compression stockings on orthostatic tolerance.<h4>Methodology/principal findings</h4>We evaluated orthostatic tolerance (OT) and haemodynamic control in 15 healthy volunteers wearing graded calf compression stockings compared to two placebo stockings in a randomized, cross-over, double-blind fashion. OT (time to presyncope, min) was determined using combined head-upright tilting and lower body negative pressure applied until presyncope. Throughout testing we continuously monitored beat-to-beat blood pressures, heart rate, stroke volume and cardiac output (finger plethysmography), cerebral and forearm blood flow velocities (Doppler ultrasound) and breath-by-breath end tidal gases. There were no significant differences in OT between compression stocking (26.0±2.3 min) and calf (29.3±2.4 min) or ankle (27.6±3.1 min) placebo conditions. Cardiovascular, cerebral and respiratory responses were similar in all conditions. The efficacy of compression stockings was related to anthropometric parameters, and could be predicted by a model based on the subject's calf circumference and shoe size (r = 0.780, p = 0.004).<h4>Conclusions/significance</h4>These data question the use of calf compression stockings for orthostatic intolerance and highlight the need for individualised therapy accounting for anthropometric variables when considering treatment with compression stockings.
format	article
author	Clare Louise Protheroe Anastasia Dikareva Carlo Menon Victoria Elizabeth Claydon
author_facet	Clare Louise Protheroe Anastasia Dikareva Carlo Menon Victoria Elizabeth Claydon
author_sort	Clare Louise Protheroe
title	Are compression stockings an effective treatment for orthostatic presyncope?
title_short	Are compression stockings an effective treatment for orthostatic presyncope?
title_full	Are compression stockings an effective treatment for orthostatic presyncope?
title_fullStr	Are compression stockings an effective treatment for orthostatic presyncope?
title_full_unstemmed	Are compression stockings an effective treatment for orthostatic presyncope?
title_sort	are compression stockings an effective treatment for orthostatic presyncope?
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/7ff35feb569245f9987364304d2ec286
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Are compression stockings an effective treatment for orthostatic presyncope?

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