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Van Remoortel H, Van de Sande D, Maes D, Khoudary J, Tavernier V, Tiberghien P, De Buck E, Compernolle V. The efficacy and effectiveness of drinking interventions to reduce vasovagal reactions in blood donors: A systematic review and meta-analysis. Vox Sang 2024. [PMID: 39237120 DOI: 10.1111/vox.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND AND OBJECTIVES Blood establishments strive to ensure the safety and comfort of blood donors while minimizing adverse events. This review aims to assess the efficacy and effectiveness of eating and/or drinking interventions before, during and/or after blood donation in reducing vasovagal reactions (VVRs). MATERIALS AND METHODS We analysed randomized and non-randomized controlled trials comparing eating and/or drinking interventions to no intervention, placebo or usual practice on (pre-)syncopal VVRs and related symptoms. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to assess the risk of bias and overall certainty of the evidence. RESULTS Pre-donation water ingestion likely results in reduced on-site VVRs, compared to no water (2 fewer per 100 donors, moderate-certainty evidence). A pre-donation isotonic drink likely results in reduced VVRs, compared to usual practice (2 fewer per 100 donors, moderate-certainty evidence). Pre-donation salt-loaded sweetened lemon water may result in fewer off-site VVRs, compared to sweetened lemon water only (1 fewer per 100 donors, low-certainty evidence). Pre-donation water and a gel cap containing sucrose with 250 mg caffeine may result in fewer blood donor reaction ratings, compared to pre-donation water only (low-certainty evidence). CONCLUSIONS Pre-donation plain water ingestion or isotonic drink probably results in a large reduction in on-site and off-site VVRs. Pre-donation water ingestion with caffeine consumption or salt supplementation may result in a VVR reduction, compared to water ingestion only. Future large trials are required to increase the certainty of the effect of these and other interventions in the prevention of VVRs.
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Affiliation(s)
- Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | | | - Dieter Maes
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Jina Khoudary
- Belgian Red Cross, Blood Services, Mechelen, Belgium
| | | | - Pierre Tiberghien
- Etablissement Français du Sang, La Pleine St Denis, France
- EFS, INSERM, UMR Right, Université de Franche-Comté, Ghent, Besançon, France
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Veerle Compernolle
- Belgian Red Cross, Blood Services, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Sanyahumbi A, Ali S, Benjamin IJ, Karthikeyan G, Okello E, Sable CA, Taubert K, Wyber R, Zuhlke L, Carapetis JR, Beaton AZ. Penicillin Reactions in Patients With Severe Rheumatic Heart Disease: A Presidential Advisory From the American Heart Association. J Am Heart Assoc 2022; 11:e024517. [PMID: 35049336 PMCID: PMC9075066 DOI: 10.1161/jaha.121.024517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Secondary antibiotic prophylaxis with regular intramuscular benzathine penicillin G (BPG) is the cornerstone of rheumatic heart disease management. However, there is a growing body of evidence that patients with rheumatic heart disease who have severe valvular heart disease with or without reduced ventricular function may be dying from cardiovascular compromise following BPG injections. This advisory responds to these concerns and is intended to: (1) raise awareness, (2) provide risk stratification, and (3) provide strategies for risk reduction. Based on available evidence and expert opinion, we have divided patients into low- and elevated-risk groups, based on symptoms and the severity of underlying heart disease. Patients with elevated risk include those with severe mitral stenosis, aortic stenosis, and aortic insuffiency; those with decreased left ventricular systolic dysfunction; and those with no symptoms. For these patients, we believe the risk of adverse reaction to BPG, specifically cardiovascular compromise, may outweigh its theoretical benefit. For patients with elevated risk, we newly advise that oral prophylaxis should be strongly considered. In addition, we advocate for a multifaceted strategy for vasovagal risk reduction in all patients with rheumatic heart disease receiving BPG. As current guidelines recommend, all low-risk patients without a history of penicillin allergy or anaphylaxis should continue to be prescribed BPG for secondary antibiotic prophylaxis. We publish this advisory in the hopes of saving lives and avoiding events that can have devastating effects on patient and clinician confidence in BPG.
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Bachowski G. Blood Donor Medical Assessment, Collection, and Complications. Transfus Med 2021. [DOI: 10.1002/9781119599586.ch4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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France CR, France JL, Himawan LK, Lux P, McCullough J. Donation related fears predict vasovagal reactions and donor attrition among high school donors. Transfusion 2020; 61:102-107. [PMID: 32997822 DOI: 10.1111/trf.16099] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND This longitudinal study of high school whole blood donors examined relationships among donation-related fears assessed prior to donation, vasovagal reactions to donation, and the proportion of donors who attempted another donation over the subsequent 60 weeks. STUDY DESIGN AND METHODS Data regarding vasovagal reactions and attempted donation were obtained from donor records of 530 female and 342 male high school donors who answered questions about five types of fear (ie, of blood draw, needles, seeing blood, feeling pain, or fainting) prior to their index donation. RESULTS Each type of fear was associated with an increased risk of vasovagal reactions (all P < .001) and a smaller percentage of attempted donations was seen among those who reported at least one type of fear (53%) as compared to those who did not report any fear (62.1%); P = .022; β = -0.374, OR = 0.69; 95% CI, 0.50-0.94. Path analyses of the relationships among fear, vasovagal reaction, and attempted donation revealed significant indirect effects for each type of fear. Specifically, donors who reported fear were at increased odds of experiencing a vasovagal reaction, which, in turn, was associated with decreased odds of attempting a repeat donation. CONCLUSION Donation-related fears are associated with reduced donor return rates, and this effect is mediated through an increased risk for vasovagal reactions. For both practical and ethical reasons, blood collectors are encouraged to identify and intervene with fearful donors to reduce the likelihood of negative donation-related symptoms and enhance donor retention.
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Affiliation(s)
| | - Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Lina K Himawan
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Pete Lux
- Blood Services, Mississippi Valley Regional Blood Center, Davenport, Iowa, USA
| | - Jeannine McCullough
- Blood Services, Mississippi Valley Regional Blood Center, Davenport, Iowa, USA
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France CR, France JL, Conatser R, Lux P, McCullough J, Erickson Y. Predonation fears identify young donors at risk for vasovagal reactions. Transfusion 2019; 59:2870-2875. [DOI: 10.1111/trf.15424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/10/2019] [Accepted: 06/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Pete Lux
- Mississippi Valley Regional Blood Center Davenport Iowa
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Kuntz JL, Firemark A, Schneider J, Henninger M, Bok K, Naleway A. Development of an Intervention to Reduce Pain and Prevent Syncope Related to Adolescent Vaccination. Perm J 2019; 23:17-136. [PMID: 30624195 DOI: 10.7812/tpp/17-136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION There is a lack of research into the perspectives of patients, parents, and clinicians regarding strategies for vaccine-related pain and syncope prevention that may improve the adolescent vaccination experience and encourage future vaccination. OBJECTIVE To develop an intervention on the basis of preference for strategies to reduce pain and prevent syncope associated with adolescent vaccination. METHODS We conducted focus groups and interviews with 8 recently vaccinated Kaiser Permanente Northwest (KPNW) members aged 11 to 17 years and their parents to explore perceptions of pain and syncope after vaccination as well as receptivity to potential interventions. Additionally, we interviewed 7 clinical staff who routinely vaccinate children. We conducted content analysis to identify promising interventions and conducted a data synthesis workshop to select a final intervention for piloting. RESULTS All participants expressed willingness to use previsit education, breathing exercises, social support or distraction, and water consumption. Patients and parents expressed a need for verbal education and messaging about potential vaccine-related outcomes, and clinicians noted a need to identify patients who are anxious before a vaccination visit. Most participants suggested a "comfort menu" intervention, to include comfort and distraction items that medical staff offer adolescents before and during vaccination. CONCLUSION Patients, parents, and clinicians acknowledged the value of interventions to reduce pain and syncope after adolescent vaccination. Stakeholders identified a comfort menu as the intervention to be piloted at 2 KPNW pediatric clinics. Further research is needed to test the effectiveness of the "Vaccination Comfort Menu" intervention in improving vaccination experiences and continued receipt of vaccinations.
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Affiliation(s)
| | | | | | | | - Karin Bok
- National Vaccine Program Office, US Department of Health and Human Services, Washington, DC
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Wiersum‐Osselton J, Romeijn B, Brekel E, Dongen A, Hermans F, Bokhorst A, Kreek T. Can we prevent vasovagal reactions in young inexperienced whole blood donors? A placebo controlled study comparing effects of a 330 vs 500 mL water drink prior to donation. Transfusion 2018; 59:555-565. [DOI: 10.1111/trf.15065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - Bas Romeijn
- Sanquin, Unit Donor Affairs Amsterdam The Netherlands
| | - Elise Brekel
- Sanquin, Unit Donor Affairs Amsterdam The Netherlands
| | - Anne Dongen
- Sanquin, Unit Donor Affairs Amsterdam The Netherlands
| | - Frank Hermans
- Sanquin, Unit Donor Affairs Amsterdam The Netherlands
| | | | - Tanneke Kreek
- Sanquin, Unit Donor Affairs Amsterdam The Netherlands
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Wong HK, Chu CCY, Lau CW, Leung JNS, Lee IYM, Lee CK. Vasovagal reaction in blood donors: prediction and its impact on donor return. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/voxs.12442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Hoi-kei Wong
- Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | | | - Ching-wa Lau
- Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | | | - Idy Yik-mun Lee
- Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
| | - Cheuk-kwong Lee
- Hong Kong Red Cross Blood Transfusion Service; Kowloon Hong Kong
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Sachdev S, Singh L, Sharma RR, Marwaha N. A Study on the Effect of Pre-donation Salt Loading on Vasovagal Reactions in Young College Going Whole Blood Donors. Indian J Hematol Blood Transfus 2017; 33:592-597. [PMID: 29075075 DOI: 10.1007/s12288-017-0787-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 01/25/2017] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The pathophysiology of vasovagal reactions (VVRs) involves both psychological and physiological components. Strategies which could allay physiological changes include interventions like pre-donation water intake and applied muscle tension have been published, however salt loading has not been tested. MATERIALS AND METHODS Cross sectional study enrolling 1000 young college going whole blood donors with intervention 250 ml of salted loaded water or plain water as placebo. The immediate VVRs were recorded with respect to age, gender, donation status, blood volume, blood volume drawn and BMI. RESULTS VVRs occurred in 25 out of 1000 (2.5%) young college going whole blood donors. Overall there were 18 VVRs in 526 (3.4%) donors in the placebo arm compared to 7 in 474 (1.5%) in salt loaded arm with odds of 2.36 (p = 0.049), however the difference in means of VVRs between the study arms could not achieve statistical significance on binary logistic regression. The independent risk factors including age, gender, blood volume, blood volume withdrawn and BMI or the donation status were not found to be effect modifiers on the occurrence of VVRs. CONCLUSION Salt loading before blood donation in young college going whole blood donors does decrease the VVRs in the immediate post donation period; however the decrease was limited to a trend and could not attain statistical significance.
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Affiliation(s)
- Suchet Sachdev
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lakhvinder Singh
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ratti Ram Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Marwaha
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Water ingestion decreases cardiac workload time-dependent in healthy adults with no effect of gender. Sci Rep 2017; 7:7939. [PMID: 28801682 PMCID: PMC5554208 DOI: 10.1038/s41598-017-08446-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/12/2017] [Indexed: 12/22/2022] Open
Abstract
Ingestion of water entails a variety of cardiovascular responses. However, the precise effect remains elusive. We aimed to determine in healthy adults the effect of water on cardiac workload and to investigate potential gender differences. We pooled data from two controlled studies where blood pressure (BP) and heart rate (HR) were continuously recorded before and after the ingestion of 355 mL of tap water. Additionally, we calculated double product by multiplying systolic BP with HR and evaluated spectral parameters referring to vagal tone. All parameters were investigated for potential differences based on gender. In response to water, HR, systolic BP, and double product decreased significantly during the first 30 min. However, these effects were attenuated for HR and double product and even abolished for systolic BP over the subsequent 30 min. Over the entire post-drink period (60 min), decreases in HR and double product (all P < 0.05) were observed. Spectral markers for vagal tone increased with the on-set of the water drink and remained elevated until the end (P < 0.005). No significant gender difference in cardiac workload parameters was observed. We provide evidence that drinking water decreases, in a time-dependent fashion, cardiac workload and that these responses appear not to be influenced by gender.
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Cure P, Bembea M, Chou S, Doctor A, Eder A, Hendrickson J, Josephson CD, Mast AE, Savage W, Sola-Visner M, Spinella P, Stanworth S, Steiner M, Mondoro T, Zou S, Levy C, Waclawiw M, El Kassar N, Glynn S, Luban NLC. 2016 proceedings of the National Heart, Lung, and Blood Institute's scientific priorities in pediatric transfusion medicine. Transfusion 2017; 57:1568-1581. [PMID: 28369923 DOI: 10.1111/trf.14100] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/30/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Pablo Cure
- Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Melania Bembea
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland
| | - Stella Chou
- Department of Hematology and the Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Allan Doctor
- Department of Pediatrics, St Louis Children's Hospital, St Louis, Missouri
| | - Anne Eder
- National Institutes of Health, Bethesda, Maryland
| | - Jeanne Hendrickson
- Department of Laboratory Medicine, Yale University, New Haven, Connecticut
| | | | - Alan E Mast
- Blood Research Institute, Blood Center of Wisconsin, and the Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Martha Sola-Visner
- Department of Newborn Medicine, Children's Hospital, Boston, Massachusetts
| | | | - Simon Stanworth
- NHS Blood and Transplant, John Radcliffe Hospital, and Oxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UK
| | - Marie Steiner
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | | | - Shimian Zou
- Division of Blood Diseases and Resources, NHLBI/NIH
| | | | - Myron Waclawiw
- National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | | | - Simone Glynn
- Division of Blood Diseases and Resources, NHLBI/NIH
| | - Naomi L C Luban
- Division of Laboratory Medicine, Children's National Health System, Washington, DC
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Blood Donor Medical Assessment and Blood Collection. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Morand C, Coudurier N, Rolland C, Thoret S, Legrand D, Tiberghien P, Bosson JL. Prevention of syncopal-type reactions after whole blood donation: a cluster-randomized trial assessing hydration and muscle tension exercise. Transfusion 2016; 56:2412-2421. [DOI: 10.1111/trf.13716] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/26/2016] [Accepted: 05/26/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Sophie Thoret
- TIMC-IMAG Université Grenoble Alpes
- INSERM CIC-1406; Grenoble France
| | | | - Pierre Tiberghien
- UMR1098, INSERM, Etablissement Français du Sang, University of Franche-Comté; Besançon France
| | - Jean-Luc Bosson
- TIMC-IMAG Université Grenoble Alpes
- INSERM CIC-1406; Grenoble France
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Yoshida M, Ando SI, Eura E, Hayashi A, Kawamura N, Narita S, Matsumoto M, Momii H, Kadokami T, Kiyokawa H. Hemodynamic response during standing test after blood donation can predict the late phase vasovagal reaction. Heart Vessels 2016; 31:1997-2003. [DOI: 10.1007/s00380-016-0829-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 03/25/2016] [Indexed: 11/28/2022]
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Odajima T, Takanashi M, Sugimori H, Tanba T, Yoshinaga K, Motoji T, Munakata M, Nakajima K, Minami M. Impact of Elevated Hemoglobin and Serum Protein on Vasovagal Reaction from Blood Donation. PLoS One 2016; 11:e0148854. [PMID: 26894814 PMCID: PMC4760651 DOI: 10.1371/journal.pone.0148854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/25/2016] [Indexed: 11/29/2022] Open
Abstract
We conducted a cross-sectional study to elucidate factors contributing to vasovagal reaction (VVR), the most frequent side effect following whole blood and apheresis donations. Complications recorded at the collection sites after voluntary donations by the Japanese Red Cross Tokyo Blood Center (JRC), in the 2006 and 2007 fiscal years, were analyzed by both univariate analysis and the multivariate conditional logistic regression model. Of 1,119,716 blood donations over the full two years, complications were recorded for 13,320 donations (1.18%), among which 67% were VVR. There were 4,303 VVR cases which had sufficient information and could be used for this study. For each VVR case, two sex- and age-matched controls (n = 8,606) were randomly selected from the donors without complications. Age, sex, body mass index (BMI), predonation blood pressure, pulse and blood test results, including total protein, albumin, and hemoglobin, were compared between the VVR group and the control group. In univariate analysis, the VVR group was significantly younger, with a lower BMI, higher blood pressure and higher blood protein and hemoglobin levels than the control group (p<0.001). Furthermore, blood protein and hemoglobin levels showed dose-dependent relationships with VVR incidences by the Cochran-Armitage trend test (p<0.01). For both sexes, after adjusting for confounders with the multivariate conditional logistic regression model, the higher than median groups for total protein (male: OR 1.97; 95%CI 1.76,-2.21; female: OR 2.29; 95%CI 2.05–2.56), albumin (male: 1.75; 1.55–1.96; female: 1.76; 1.57–1.97) and hemoglobin (male: 1.98; 1.76–2.22; female: 1.62; 1.45–1.81) had statistically significant higher risk of VVR compared to the lower than median groups. These elevated serum protein and hemoglobin levels might offer new indicators to help understand VVR occurrence.
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Affiliation(s)
- Takeshi Odajima
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Koto-ku, Tokyo, Japan
| | | | - Hiroki Sugimori
- Department of Sports and Health Science, Daito Bunka University, Higashimatsuyama, Saitama, Japan
- * E-mail:
| | - Taiko Tanba
- Department of Sports and Health Science, Daito Bunka University, Higashimatsuyama, Saitama, Japan
| | - Kentaro Yoshinaga
- Department of Haematology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Toshiko Motoji
- Department of Haematology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Masaya Munakata
- Department of Sports and Health Science, Daito Bunka University, Higashimatsuyama, Saitama, Japan
| | - Kazunori Nakajima
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Koto-ku, Tokyo, Japan
| | - Mutsuhiko Minami
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Koto-ku, Tokyo, Japan
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Abstract
The objective of this article is to provide a review of the fundamental aspects of body fluid balance and the physiological consequences of water imbalances, as well as discuss considerations for the optimal composition of a fluid replacement beverage across a broad range of applications. Early pioneering research involving fluid replacement in persons suffering from diarrheal disease and in military, occupational, and athlete populations incurring exercise- and/or heat-induced sweat losses has provided much of the insight regarding basic principles on beverage palatability, voluntary fluid intake, fluid absorption, and fluid retention. We review this work and also discuss more recent advances in the understanding of fluid replacement as it applies to various populations (military, athletes, occupational, men, women, children, and older adults) and situations (pathophysiological factors, spaceflight, bed rest, long plane flights, heat stress, altitude/cold exposure, and recreational exercise). We discuss how beverage carbohydrate and electrolytes impact fluid replacement. We also discuss nutrients and compounds that are often included in fluid-replacement beverages to augment physiological functions unrelated to hydration, such as the provision of energy. The optimal composition of a fluid-replacement beverage depends upon the source of the fluid loss, whether from sweat, urine, respiration, or diarrhea/vomiting. It is also apparent that the optimal fluid-replacement beverage is one that is customized according to specific physiological needs, environmental conditions, desired benefits, and individual characteristics and taste preferences.
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Vavic N, Pagliariccio A, Bulajic M, Dinić R, Marinozzi M. Giving blood donors something to drink before donation can prevent fainting symptoms: is there a physiological or psychological reason? Transfus Apher Sci 2014; 51:65-9. [DOI: 10.1016/j.transci.2014.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 01/31/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
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Saito F, Shimazu T, Miyamoto J, Maemura T, Satake M. Interstitial fluid shifts to plasma compartment during blood donation. Transfusion 2013; 53:2744-50. [PMID: 23441629 DOI: 10.1111/trf.12120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 12/06/2012] [Accepted: 12/12/2012] [Indexed: 01/19/2023]
Affiliation(s)
- Fumiko Saito
- Japanese Red Cross Tokyo Metropolitan West Blood Center; Tachikawa Tokyo Japan
- Japanese Red Cross Aichi Blood Center; Nagoya Aichi Japan
- Jiseikai Bethlehem Garden Hospital; Kiyose Tokyo Japan
| | - Tomoko Shimazu
- Japanese Red Cross Tokyo Metropolitan West Blood Center; Tachikawa Tokyo Japan
- Japanese Red Cross Aichi Blood Center; Nagoya Aichi Japan
- Jiseikai Bethlehem Garden Hospital; Kiyose Tokyo Japan
| | - Junko Miyamoto
- Japanese Red Cross Tokyo Metropolitan West Blood Center; Tachikawa Tokyo Japan
- Japanese Red Cross Aichi Blood Center; Nagoya Aichi Japan
- Jiseikai Bethlehem Garden Hospital; Kiyose Tokyo Japan
| | - Taisei Maemura
- Japanese Red Cross Tokyo Metropolitan West Blood Center; Tachikawa Tokyo Japan
- Japanese Red Cross Aichi Blood Center; Nagoya Aichi Japan
- Jiseikai Bethlehem Garden Hospital; Kiyose Tokyo Japan
| | - Masahiro Satake
- Japanese Red Cross Tokyo Metropolitan West Blood Center; Tachikawa Tokyo Japan
- Japanese Red Cross Aichi Blood Center; Nagoya Aichi Japan
- Jiseikai Bethlehem Garden Hospital; Kiyose Tokyo Japan
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France CR, France JL, Wissel ME, Ditto B, Dickert T, Himawan LK. Donor anxiety, needle pain, and syncopal reactions combine to determine retention: a path analysis of two-year donor return data. Transfusion 2013; 53:1992-2000. [PMID: 23305267 DOI: 10.1111/trf.12069] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/08/2012] [Accepted: 11/08/2012] [Indexed: 12/29/2022]
Abstract
BACKGROUND Efforts to expand the donor pool by recruiting younger donors have resulted in higher numbers of initial donations, but retention of young donors continues to be challenging. STUDY DESIGN AND METHODS Path analysis was used to examine the simultaneous relationships among syncopal reactions, donation anxiety, needle pain, donor satisfaction, and donation intention in predicting repeat donation. Participants included 421 first- and second-time donors recruited for a study comparing the effects of predonation water loading with and without the use of applied muscle tension during donation (52% female, 60.8% first-time donor, mean age 20.3 years). For this longitudinal follow-up study, donor database records were accessed 2 years after the index donation to assess repeat donation. RESULTS Results of a series of path analyses demonstrated the influential role of donor anxiety in shaping donor retention (final model χ(2) = 35.75, root mean square error of approximation 0.03, comparative fit index 0.98, weighted root mean square residual 0.74). First, anxiety exerted a direct negative influence on donation intention, the proximal and sole direct predictor of repeat donation. Second, anxiety increased the likelihood of donor-reported needle pain, adversely affecting donation satisfaction and, subsequently, donation intention. Finally, anxiety was associated with donor ratings of syncopal reactions through its impact on needle pain, which also contributed to decreased donation intention. CONCLUSION These results provide novel evidence that donation anxiety plays a central role in shaping future donation behavior. Individual differences in anxiety must be considered when developing and testing strategies to enhance blood donor retention.
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Affiliation(s)
- Christopher R France
- Ohio University, Athens, Ohio; American Red Cross, Blood Services, Central Ohio Region, Columbus, Ohio; McGill University, Montreal, Quebec, Canada
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van den Berg K, Lam J, Bruhn R, Custer B, Murphy EL. Water administration and the risk of syncope and presyncope during blood donation: a randomized clinical trial. Transfusion 2012; 52:2577-84. [PMID: 22486209 PMCID: PMC3404162 DOI: 10.1111/j.1537-2995.2012.03631.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Blood centers rely heavily on adolescent donors to meet blood demand, but presyncope and syncope are more frequent in younger donors. Studies have suggested administration of water before donation may reduce syncope and/or presyncope in this group. STUDY DESIGN AND METHODS We conducted a randomized, controlled trial to establish the effect of preloading with 500 mL of water on the rate of syncope and presyncope in adolescent donors. School collection sites in Eastern Cape Province of South Africa were randomized to receive water or not. Incidence of syncope and presyncope was compared between randomization groups using multivariable logistic regression. RESULTS Of 2464 study participants, 1337 received water and 1127 did not; groups differed slightly by sex and race. Syncope or presyncope was seen in 23 (1.7%) of the treatment and 18 (1.6%) of the control arm subjects. After adjusting for race, sex, age, and donation history, there was no difference in outcome between the water versus no water arms (adjusted odds ratio [OR], 0.80; 95% confidence interval [CI], 0.42-1.53). Black donors had sevenfold lower odds of syncope or presyncope than their white counterparts (adjusted OR, 0.14; 95% CI, 0.04-0.47). CONCLUSION Preloading adolescent donors with 500 mL of water did not have a major effect in reducing syncope and presyncope in South African adolescent donors. Our adolescent donors had lower overall syncope and presyncope rates than similar populations in the United States, limiting the statistical power of the study. We confirmed much lower rates of syncope and presyncope among young black donors.
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Endo MY, Kajimoto C, Yamada M, Miura A, Hayashi N, Koga S, Fukuba Y. Acute effect of oral water intake during exercise on post-exercise hypotension. Eur J Clin Nutr 2012; 66:1208-13. [DOI: 10.1038/ejcn.2012.139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Eder AF, Notari EP, Dodd RY. Do reactions after whole blood donation predict syncope on return donation? Transfusion 2012; 52:2570-6. [DOI: 10.1111/j.1537-2995.2012.03666.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Blood Donor Medical Assessment and Blood Collection. Transfus Med 2011. [DOI: 10.1002/9781444398748.ch4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Amrein K, Valentin A, Lanzer G, Drexler C. Adverse events and safety issues in blood donation--a comprehensive review. Blood Rev 2011; 26:33-42. [PMID: 21996651 DOI: 10.1016/j.blre.2011.09.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Although blood donation is generally safe, a variety of risks and complications exist, the most common being iron deficiency, vasovagal reactions and citrate-related events. In the last decades, extensive efforts have significantly improved recipient and product safety, but there is still great potential to optimise donor care. Many therapies in modern medicine depend on the prompt availability of blood products, therefore it is crucial to maintain a motivated and healthy donor pool in view of a limited number of healthy volunteers willing and able to give blood or blood components. We present a comprehensive review on adverse events addressing all types of blood donation including whole blood, plasma, platelet, peripheral blood stem cell, leucocyte and bone marrow donation. In addition, we outline strategies for the prevention and treatment of these events and give a blueprint for future research in this field.
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Affiliation(s)
- Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Auenbruggerplatz 15, 8036 Graz, Austria.
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26
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Wieling W, France CR, van Dijk N, Kamel H, Thijs RD, Tomasulo P. Physiologic strategies to prevent fainting responses during or after whole blood donation. Transfusion 2011; 51:2727-38. [DOI: 10.1111/j.1537-2995.2011.03202.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Water drinking elicits profound pressor responses in patients with impaired baroreflex function and in sinoaortic-denervated mice. Healthy subjects show more subtle changes in heart rate and blood pressure with water drinking. The water-induced pressor response appears to be mediated through sympathetic nervous system activation at the spinal level. Indeed, water drinking raises resting energy expenditure in normal weight and obese subjects. The stimulus setting off the response is hypoosmolarity rather than water temperature or gastrointestinal stretch. Studies in mice suggest that this osmopressor response may involve transient receptor potential vanniloid 4 (Trpv4) receptors. However, the (nerve) cell population serving as peripheral osmosensors and the exact transduction mechanisms are still unknown. The osmopressor response can be exploited in the treatment of orthostatic and postprandial hypotension in patients with severe autonomic failure. Furthermore, the osmopressor response acutely improves orthostatic tolerance in healthy subjects and in patients with neurally mediated syncope. The phenomenon should be recognized as an important confounder in cardiovascular and metabolic studies.
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Affiliation(s)
- Marcus May
- Institute of Clinical Pharmacology, Hannover, Germany
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28
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Bani M, Giussani B. Gender differences in giving blood: a review of the literature. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2010; 8:278-87. [PMID: 20967170 PMCID: PMC2957494 DOI: 10.2450/2010.0156-09] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 02/18/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND An overview of European blood donors shows that the distribution of men and women donors is similar in many countries, with Italy being an exception in that women account for only 30% of donors. Gender medicine is a key issue in this context, even though gender studies are very limited in the transfusion field, whether considered broadly or with specific regards to the selection, management and retention of donors. It, therefore, seemed important to compare the presence of women among blood donors in different European countries and examine the roles that gender is reported to play in the donation of blood in order to identify possible implications for communication with and management of the donor. METHODS To determine the proportion of women among donors in European countries, data were collected from annual reports or documents available on the websites of national associations; furthermore, all papers related to giving blood published in the five main journals in the sector (Transfusion, Vox Sanguinis, Transfusion and Apheresis Science, Transfusion Medicine, Blood Transfusion) were considered; about 80 publications were selected and the gender variable was examined. RESULTS The published studies showed that gender plays key roles in the motivation to give blood (women being more altruistic, men being more individualistic) and in adverse reactions, which was a particularly critical problem leading to fewer women become regular donors. A few aspects specific to the management of donors in Italy also emerged. DISCUSSION Gender seems to play an important role in the aspects studied and does, therefore, merit further consideration in relation to strategies to recruit donors and the management of critical events during donation.
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Affiliation(s)
- Marco Bani
- Multimedia Health Communication Laboratory, Facoltà di Medicina e Chirurgia, Università di Milano Bicocca, Monzo, Italy.
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29
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Abstract
This review examines the current knowledge of water intake as it pertains to human health, including overall patterns of intake and some factors linked with intake, the complex mechanisms behind water homeostasis, and the effects of variation in water intake on health and energy intake, weight, and human performance and functioning. Water represents a critical nutrient, the absence of which will be lethal within days. Water's importance for the prevention of nutrition-related noncommunicable diseases has received more attention recently because of the shift toward consumption of large proportions of fluids as caloric beverages. Despite this focus, there are major gaps in knowledge related to the measurement of total fluid intake and hydration status at the population level; there are also few longer-term systematic interventions and no published randomized, controlled longer-term trials. This review provides suggestions for ways to examine water requirements and encourages more dialogue on this important topic.
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Affiliation(s)
- Barry M Popkin
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina 27516, USA.
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France CR, Ditto B, Wissel ME, France JL, Dickert T, Rader A, Sinclair K, McGlone S, Trost Z, Matson E. Predonation hydration and applied muscle tension combine to reduce presyncopal reactions to blood donation. Transfusion 2010; 50:1257-64. [PMID: 20113455 PMCID: PMC2935324 DOI: 10.1111/j.1537-2995.2009.02574.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A randomized controlled trial was conducted to test the effects of hydration and applied muscle tensing on presyncopal reactions to blood donation. Both interventions are designed to prevent the decreases in blood pressure that can contribute to such reactions, but due to the distinct physiologic mechanisms underlying their pressor responses it was hypothesized that a combined intervention would yield the greatest benefit. STUDY DESIGN AND METHODS Before blood donation, first- and second-time blood donors (mean age, 20.2 years; SD, 4.9) were randomly assigned to 1) standard donation, 2) placebo (leg exercise before venipuncture), 3) predonation water, or 4) predonation water and leg exercise during donation. RESULTS Main effects of group were observed for phlebotomist classification of vasovagal reactions (chi(2)(3) = 8.38, p < 0.05) and donor reports of presyncopal reactions (chi(2)(3) = 13.16, p < 0.01). Follow-up analyses of phlebotomist classifications revealed fewer reactions in the predonation water and predonation water and leg exercise groups relative to placebo but not standard donation. Follow-up analyses of self-reported reactions revealed that women, but not men, had lower scores in both the predonation water and the predonation water and leg exercise groups relative to both placebo and standard donation. CONCLUSIONS Predonation hydration and a combination of hydration and leg exercise may help attenuate presyncopal reactions in relatively novice donors, although future studies with larger samples are required to confirm this effect.
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Ando SI, Imaizumi T. Akira Takeshita, MD, PhD. Circ J 2009. [DOI: 10.1253/circj.cj-09-0397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shin-ichi Ando
- Cardiology Division, Fukuoka Ken Saiseikai Futsukaichi Hospital
| | - Tsutomu Imaizumi
- Department of Medicine, Division of Cardio-Vascular Disease, Kurume University School of Medicine
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