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

A Moya

A Radtke

AA Smit

Anastasia Dikareva

C Podoleanu

C Schroeder

Carlo Menon

Clare Louise Protheroe

CM Brown

CT Krediet

DD Savage

FS Larsen

Giuseppe Biondi-Zoccai

H El Sayed

JC Denq

JJ Romme

KH Wesseling

KM El Bedawi

L Walker

LJ Norcliffe-Kaufmann

LR Olde Nordkamp

LY Chen

MB Stenger

ME Petersen

MP Harms

MS Rose

NJ Fuller

P Karakas

R Hainsworth

R Maggi

R Sutton

RD Thijs

S Avril

S Raju

SE Privett

SH Platts

SP Downie

T Benko

T Lewis

VE Bush

VE Claydon

Victoria Elizabeth Claydon

WN Kapoor

WT Jellema

YMA Al Shamma

PLoS ONE

English

PubMed

BackgroundSyncope, 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.Methodology/principal findingsWe 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).Conclusions/significanceThese 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

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Are compression stockings an effective treatment for orthostatic presyncope?

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.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).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

Protheroe Clare Louise

Dikareva Anastasia

Menon Carlo

Claydon Victoria Elizabeth

Public Library of Science (PLOS)

Are Compression Stockings an Effective Treatment for Orthostatic Presyncope?

Protheroe, Clare

Dikareva, Anastasia

Claydon, Victoria

Menon, Carlo

Simon Fraser University Institutional Repository

Crossref

A quantitative comparison of the circulatory responses in humans to graded upright tilting and graded lower body negative pressure.

Assessment of capillary fluid shifts during orthostatic stress in normal subjects and subjects with orthostatic intolerance.

Cardiac pacing does not improve orthostatic tolerance in patients with vasovagal syncope.

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Are Compression Stockings an Effective Treatment for Orthostatic Presyncope?

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