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Nakagawa S, Shima H, Sakurai Y. Meteorological factors associated with the occurrence of the vasovagal reflex during blood donation. Transfus Clin Biol 2024; 31:181-185. [PMID: 38604405 DOI: 10.1016/j.tracli.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
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Hashizume T, Kondo G, Ishimaru F, Ikeda Y, Kagawa K, Kunii N, Namba N, Aoki K, Sawamura Y, Makino S. Development and validation of a scoring system to predict vasovagal reaction upon whole-blood donation. Vox Sang 2024; 119:300-307. [PMID: 38156553 DOI: 10.1111/vox.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Risk factors for vasovagal reaction (VVR) have been extensively studied. With knowledge of the relative importance of these risk factors for VVR, collection staff could take care of blood donors from the same standpoint, leading to improved donor safety. We therefore developed a scoring system to predict VVR, which incorporates registration information. MATERIALS AND METHODS Pre-syncopal and syncopal symptoms, as well as on- and off-site reactions, are included in this analysis as VVR. We defined the donor status as follows: first-time donors, repeat donors with no history of reaction and repeat donors with a history of reaction. We prepared two datasets: whole-blood donations at a blood donation site in Tokyo between January 2019 and December 2019 were included in training data (n = 361,114), and whole-blood donations between January 2020 and August 2020 were included in testing data (n = 216,211). RESULTS The most important variable was the donor status, followed by age, estimated blood volume and height. We integrated them into a scoring system. Training and testing datasets were combined (n = 577,325), and VVR rates in groups with scores of 0, 1, 2, 3, 4 and 5 or more were 0.09% (95% CI: 0.081%-0.10%), 0.33% (95% CI: 0.31%-0.36%), 0.87% (95% CI: 0.78%-0.96%), 1.17% (95% CI: 1.05%-1.30%), 2.15% (95% CI: 1.98%-2.32%) and 3.11% (95% CI: 2.90%-3.34%), respectively. CONCLUSION The scoring system enables staff to significantly predict VVR and may help them to identify donors at increased risk of experiencing syncope, thereby mitigating the negative impact of VVR on donor safety and return by paying close attention to high-risk donors.
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Affiliation(s)
| | - Gaku Kondo
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | | | - Yoko Ikeda
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | - Keiko Kagawa
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | - Noriko Kunii
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | - Noriko Namba
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | - Kiichi Aoki
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
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Lu H, Zhang Y, Liu P. Identifying new safety risk of human serum albumin: a retrospective study of real-world data. Front Pharmacol 2024; 15:1319900. [PMID: 38292942 PMCID: PMC10825956 DOI: 10.3389/fphar.2024.1319900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
Objective: To mine and analyze the adverse reaction signals of human serum albumin (HSA) using the FDA adverse event reporting system (FAERS) database for the safe clinical use of this drug. Methods: Data cleaning and analysis of adverse event reports in the FAERS database for a total of 76 quarters from Q1 2004 to Q4 2022 were performed using the reporting odds ratio (ROR), Medicines and Healthcare Products Regulatory Agency (MHRA), and Bayesian confidence propagation neural network (BCPNN). Gender-differentiated signal detection was used to investigate the gender differences in the occurrence of HSA adverse events. Results: Through a combination of three methods, a total of 535 adverse event reports were identified. These reports involved 1,885 cases of adverse reactions, with respiratory, thoracic, and mediastinal disorders, as well as general disorders and administration site conditions, as the most common. One noteworthy new signal was the occurrence of transfusion-related acute lung injury. Additionally, gender-differentiated signals were present, with females experiencing paraesthesia, hypertension, pulmonary oedema, loss of consciousness, and vomiting. Conclusion: This study has revealed that HSA poses a risk of causing transfusion-related acute lung injury. It has also been observed that adverse reactions, including paraesthesia, hypertension, pulmonary oedema, loss of consciousness, and vomiting, are more prevalent in females. These findings should be taken into account when using HSA in a clinical setting.
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Affiliation(s)
- Hui Lu
- Shanghai RAAS Blood Products Co., Ltd., Shanghai, China
| | - Yuwei Zhang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Pengcheng Liu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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Nair AR, Gupta D. Severe donor reaction as a hazard of replacement blood donation. Asian J Transfus Sci 2024; 18:128-130. [PMID: 39036673 PMCID: PMC11259347 DOI: 10.4103/ajts.ajts_22_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/21/2022] [Accepted: 03/06/2022] [Indexed: 11/04/2022] Open
Abstract
Blood donation is generally considered to be a safe procedure, but occasionally adverse reactions of varying severity may occur predonation, donation, or postdonation phases. Various studies have reported the incidence of adverse donor reaction as 0.6%-5.6%. Donor reactions are classified into mild, moderate, and severe types or immediate and delayed. Although delayed reactions account for <2% of total adverse donor reactions, 27.6% are severe with or without injury. Herein, we report a case of potentially preventable delayed Grade 2 vasovagal reaction in a 56-year-old replacement blood donor.
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Affiliation(s)
- Amita Radhakrishnan Nair
- Department of Transfusion Medicine, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Debasish Gupta
- Department of Transfusion Medicine, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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Jiang Y, Lin J, Ding R, Li L, Chi H, Zhang L, Xia X, Yu Y, Pi H. A new risk predictive scoring system of vasovagal reactions in patients with preoperative autologous blood donation. Transfus Apher Sci 2023; 62:103791. [PMID: 37633760 DOI: 10.1016/j.transci.2023.103791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Vasovagal response (VVR) is the most common adverse reaction during blood donation and it is the main element for the safety of the patients with preoperative autologous blood donation (PABD). Accurate identification high-risk group is of great significance for PABD. Our study aimed to establish a scoring system based on the nomogram to screen the high-risk population and provide evidence for preventing the occurrence of VVRs. MATERIALS AND METHODS A number of 4829 patients underwent PABD between July 2017 and June 2020 in the first medical center of Chinese PLA Hospital were recruited, 3387 of whom were included in the training group (70 %; 108 VVRs patients vs 3279 Non-VVRs patients), 1442 were included in the validation group (30 %; 46 VVRs patients vs 1396 Non-VVRs patients). The data were analyzed by univariate and multivariate logistic regression. The nomogram of the scoring system was created by using the RMS tool in R software. RESULTS Seven variables including BMI, hematocrit, pre-phlebotomy heart rate and systolic blood pressure, history of blood donation, age group and primary disease were selected to build the nomogram, which was shown as prediction model. And the score was 0-1 for BMI, 0-2 for hematocrit, systolic blood pressure, heart rate and no blood donation history, 0-10 for age, 0-3 for primary disease. When the total cutoff score was 11, the predictive system for identifying VVRs displayed higher diagnostic accuracy. The area under the curve, specificity, and sensitivity of the training group were 0.942, 82.41 % and 97.17 %, respectively, whereas those of the validation group were 0.836, 78.26 % and 78.15 %, respectively. CONCLUSION A risk predictive scoring system was successfully developed to identify high-risk VVRs group form PABD patients that performed well.
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Affiliation(s)
- Ying Jiang
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jie Lin
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ruiqing Ding
- Key Lab of High Confidence Software Technologies (Peking University), Ministry of Education School of Computer Science, Peking University, Beijing, China
| | - Lingling Li
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongxu Chi
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Leiying Zhang
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xingqiu Xia
- Beijing HealSci Technology Co., Ltd., Beijing, China
| | - Yang Yu
- Transfusion Medicine Department, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Hongying Pi
- Health Service Training Center, Chinese PLA General Hospital, Beijing, China.
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Wei WH, Smith M, Vera A, Meads K, Hessell J, Reid L, Scott L, Burge A, Kirwan S, Charlewood R, Sadani D, Walkden D, Chand A. Novel risk patterns of vasovagal reactions in NZ blood donations complicated by COVID-19 restrictions. Front Public Health 2023; 11:1180279. [PMID: 37304099 PMCID: PMC10248232 DOI: 10.3389/fpubh.2023.1180279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Vasovagal reactions (VVRs) are common but complex donor adverse reactions (DAEs) in blood donations. VVRs have been extensively studied with a multitude of risk factors identified including young age, female gender and first-time donor status. How they may interplay remains obscure. Methods A total of 1,984,116 blood donations and 27,952 immediate VVRs (iVVRs) and 1,365 delayed VVRs (dVVRs) reported between 2011 and 2021 in NZ were used in multivariate logistic regression analyses each concerning donations with iVVRs as cases and those free of DAEs as controls. For each analysis stepwise selection was used to identify the best model and risk factors carrying significant main effects and/or interactions. Identified interactions informed further in-depth regression analyses to dissect iVVR risk patterns. Results Over 95% of VVRs were iVVRs that had lower female preponderance and deferrals than dVVRs. iVVRs had a school seasonal pattern in whole blood donations driven by first-time donors from schools/colleges, and interactions between gender and age group differentiating the first-time from repeat donations. Subsequent regression analyses identified the known and novel risk factors of year and mobile collection sites and their interactions. iVVR rates were roundly elevated in 2020 and 2021 probably because of COVID-19 restrictions like facemask wearing. Exclusion of the 2020 and 2021 data removed the interactions with year, but confirmed interactions of gender with mobile collection sites (p = 6.2e-07) in first-time donations only and with age group in repeat donations only (p < 2.2e-16), together indicating young female donors at the highest risk of iVVRs. Our results also revealed that donation policy changes contributed to the year effects; donors had a lower iVVR risk at mobile sites than well-medicalized donation centers probably because of under-reporting. Conclusion Modeling statistical interactions is valuable in identifying odds and revealing novel iVVR risk patterns and insights into blood donations.
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Affiliation(s)
- Wen-Hua Wei
- New Zealand Blood Service, Auckland, New Zealand
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, The University of Manchester, Manchester, United Kingdom
| | | | - Amber Vera
- New Zealand Blood Service, Auckland, New Zealand
| | - Kelly Meads
- New Zealand Blood Service, Auckland, New Zealand
| | | | - Laura Reid
- New Zealand Blood Service, Auckland, New Zealand
| | - Lisa Scott
- New Zealand Blood Service, Auckland, New Zealand
| | - Asuka Burge
- New Zealand Blood Service, Auckland, New Zealand
| | - Susy Kirwan
- New Zealand Blood Service, Auckland, New Zealand
| | | | | | | | - Anup Chand
- New Zealand Blood Service, Auckland, New Zealand
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Aegisdottir HM, Thorolfsdottir RB, Sveinbjornsson G, Stefansson OA, Gunnarsson B, Tragante V, Thorleifsson G, Stefansdottir L, Thorgeirsson TE, Ferkingstad E, Sulem P, Norddahl G, Rutsdottir G, Banasik K, Christensen AH, Mikkelsen C, Pedersen OB, Brunak S, Bruun MT, Erikstrup C, Jacobsen RL, Nielsen KR, Sørensen E, Frigge ML, Hjorleifsson KE, Ivarsdottir EV, Helgadottir A, Gretarsdottir S, Steinthorsdottir V, Oddsson A, Eggertsson HP, Halldorsson GH, Jones DA, Anderson JL, Knowlton KU, Nadauld LD, Haraldsson M, Thorgeirsson G, Bundgaard H, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Ostrowski SR, Holm H, Stefansson K. Genetic variants associated with syncope implicate neural and autonomic processes. Eur Heart J 2023; 44:1070-1080. [PMID: 36747475 DOI: 10.1093/eurheartj/ehad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 11/22/2022] [Accepted: 01/05/2023] [Indexed: 02/08/2023] Open
Abstract
AIMS Syncope is a common and clinically challenging condition. In this study, the genetics of syncope were investigated to seek knowledge about its pathophysiology and prognostic implications. METHODS AND RESULTS This genome-wide association meta-analysis included 56 071 syncope cases and 890 790 controls from deCODE genetics (Iceland), UK Biobank (United Kingdom), and Copenhagen Hospital Biobank Cardiovascular Study/Danish Blood Donor Study (Denmark), with a follow-up assessment of variants in 22 412 cases and 286 003 controls from Intermountain (Utah, USA) and FinnGen (Finland). The study yielded 18 independent syncope variants, 17 of which were novel. One of the variants, p.Ser140Thr in PTPRN2, affected syncope only when maternally inherited. Another variant associated with a vasovagal reaction during blood donation and five others with heart rate and/or blood pressure regulation, with variable directions of effects. None of the 18 associations could be attributed to cardiovascular or other disorders. Annotation with regard to regulatory elements indicated that the syncope variants were preferentially located in neural-specific regulatory regions. Mendelian randomization analysis supported a causal effect of coronary artery disease on syncope. A polygenic score (PGS) for syncope captured genetic correlation with cardiovascular disorders, diabetes, depression, and shortened lifespan. However, a score based solely on the 18 syncope variants performed similarly to the PGS in detecting syncope risk but did not associate with other disorders. CONCLUSION The results demonstrate that syncope has a distinct genetic architecture that implicates neural regulatory processes and a complex relationship with heart rate and blood pressure regulation. A shared genetic background with poor cardiovascular health was observed, supporting the importance of a thorough assessment of individuals presenting with syncope.
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Affiliation(s)
- Hildur M Aegisdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | | | | | | | | | | | | | | | | | - Egil Ferkingstad
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Patrick Sulem
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Alex Hoerby Christensen
- The Unit for Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 1, Herlev 2730, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
- Department of Clinical Immunology, Zealand University Hospital - Køge, Lykkebækvej 1, Køge 4600, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, Aarhus 8000, Denmark
| | - Rikke Louise Jacobsen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Urbansgade 32, Aalborg 9000, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Michael L Frigge
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Anna Helgadottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Asmundur Oddsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - David A Jones
- Precision Genomics, Intermountain Healthcare, 600 S. Medical Center Drive, Saint George, UT 84790, USA
| | - Jeffrey L Anderson
- Intermountain Medical Center, Intermountain Heart Institute, 5171 S. Cottonwood Street Building 1, Salt Lake City, UT 84107, USA
- Department of Internal Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT 84132, USA
| | - Kirk U Knowlton
- Intermountain Medical Center, Intermountain Heart Institute, 5171 S. Cottonwood Street Building 1, Salt Lake City, UT 84107, USA
- School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT 84132, USA
| | - Lincoln D Nadauld
- Precision Genomics, Intermountain Healthcare, 600 S. Medical Center Drive, Saint George, UT 84790, USA
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA
| | | | - Magnus Haraldsson
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
- Department of Psychiatry, Landspitali, The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
- Department of Medicine, Landspitali, The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Henning Bundgaard
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
- The Capital Regions Unit for Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
- Department of Medicine, Landspitali, The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Hjardarhagi 4, Reykjavik 107, Iceland
| | - Sisse R Ostrowski
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
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Suessner S, Niklas N, Bodenhofer U, Meier J. Machine learning-based prediction of fainting during blood donations using donor properties and weather data as features. BMC Med Inform Decis Mak 2022; 22:222. [PMID: 35987636 PMCID: PMC9392313 DOI: 10.1186/s12911-022-01971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background and objectives Fainting is a well-known side effect of blood donation. Such adverse experiences can diminish the return rate for further blood donations. Identifying factors associated with fainting could help prevent adverse incidents during blood donation. Materials and methods Data of 85,040 blood donations from whole blood and apheresis donors within four consecutive years were included in this retrospective study. Seven different machine learning models (random forests, artificial neural networks, XGradient Boosting, AdaBoost, logistic regression, K nearest neighbors, and support vector machines) for predicting fainting during blood donation were established. The used features derived from the data obtained from the questionnaire every donor has to fill in before the donation and weather data of the day of the donation. Results One thousand seven hundred fifteen fainting reactions were observed in 228 846 blood donations from 88,003 donors over a study period of 48 months. Similar values for all machine learning algorithms investigated for NPV, PPV, AUC, and F1-score were obtained. In general, NPV was above 0.996, whereas PPV was below 0.03. AUC and F1-score were close to 0.9 for all models. Essential features predicting fainting during blood donation were systolic and diastolic blood pressure and ambient temperature, humidity, and barometric pressure. Conclusion Machine-learning algorithms can establish prediction models of fainting in blood donors. These new tools can reduce adverse reactions during blood donation and improve donor safety and minimize negative associations relating to blood donation.
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Brunson DC, Belanger GA, Sussmann H, Fine AM, Pandey S, Pham TD. Factors associated with first-time and repeat blood donation: Adverse reactions and effects on donor behavior. Transfusion 2022; 62:1269-1279. [PMID: 35510783 DOI: 10.1111/trf.16893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blood centers have a dual mission to protect donors and patients; donor safety is paramount to maintaining an adequate blood supply. Elucidating donor factors associated with adverse reactions (AR) is critical to this mission. STUDY DESIGN/METHODS A retrospective cohort analysis of whole blood donors from 2003 to 2020 was conducted at a single blood center in northern California. Adjusted odds ratios (AORs) with 95% CIs for ARs were estimated via multivariable logistic regression on demographics, donation history, and physical examination data. Where appropriate, Wilcoxon-Rank Sum and chi-squared tests were used to determine significance. RESULTS First-time blood donors (FTD) exhibited a higher AR rate than repeat donors (4.4% vs. 1.9% p < .0001). When compared with FTDs without AR, FTDs with ARs (FT-AR) were less likely to return (30.0% vs. 47.3%, p < .0001), and, of those who returned, had a higher rate of reaction 20.2% versus 2.8% (p < .001). Factors found to be associated with FT-AR (younger age, increased heart rate, and higher diastolic blood pressure) still correlated positively with AR on return donation, but to a lower degree. FTD who potentially witnessed an AR had a lower return rate (44.6% vs. 47.3%, p = <.001) and donated fewer units (2.38 vs. 3.37, p < .001) when compared to FTD who did not witness an AR. CONCLUSION The AR on FTD increases the AR likelihood of return donation. Longitudinal analysis shows that a time-based deferral policy targeted at FT-AR young donors can reduce the number of ARs while not dramatically impacting the blood supply.
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Affiliation(s)
- Dalton C Brunson
- Stanford School of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | | | | | - Andrew M Fine
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Suchitra Pandey
- Stanford Blood Center, Palo Alto, California, USA.,Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Tho D Pham
- Stanford Blood Center, Palo Alto, California, USA.,Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
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10
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Nalini YC, Basavarajegowda A. Syncopal reactions in blood donors: Pathophysiology, clinical course, and features. Asian J Transfus Sci 2022. [DOI: 10.4103/ajts.ajts_167_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Fraile N, Fernández-Cano E, Ramos A, López-Aguilar JC, Jiménez-Moreno ME, Pereira A. Vasovagal syncope after blood donation in active duty military personnel of the Spanish Army. Transfusion 2021; 61:2925-2929. [PMID: 34414580 DOI: 10.1111/trf.16603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/11/2021] [Accepted: 07/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND All studies of vasovagal syncope (VVS) after blood donation have been performed with civilian donors. We hypothesized that military donors have a lower incidence of VVS and a particular set of predisposing factors. STUDY DESIGN AND METHODS Retrospective case-control study matching every case of VVS seen from 2011 to 2019 with two controls without VVS from the same blood drive. We used the odds ratio (OR) and its 95% confidence interval (CI), estimated by multivariate logistic regression, to identify independent predictors of VVS. RESULTS There were 105 episodes of VVS among 65.481 whole blood donations (0.15%). VVS was more frequent among donors from military academies than from other military units (0.37% vs. 0.10%, p < .001) and in collections conducted in mobile inside setups than in mobile buses (0.23% vs. 0.06%, p < .001). In the multivariate analysis, the only independent predictors of VVS were the status of first-time donor (OR 2.6, 95% CI 1.5-4.4; p < .001) and pre-donation systolic blood pressure (SBP) < 120 mm Hg (OR 1.9, 95% CI 1.1-3.3; p = .01). Donors with both risk factors had a 5.5-fold increased risk of VVS than donors without any risk factor. Age and female sex were not predictive of VVS. DISCUSSION Active duty military blood donors have a lower incidence of VVS than that reported in civilian donors. First-time donors and donors with SBP < 120 mm Hg should be temporarily deferred when immediate reincorporation to hazardous or strenuous duty tasks after donation is inescapable.
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Affiliation(s)
- Nuria Fraile
- Blood Transfusion Center of the Spanish Army, Madrid, Spain
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12
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Srivastava A, Kumar S, Agarwal A, Khetan D, Katharia R, Mishra P, Khati S, Gautam S, Sandeep K. Evaluation of efficacy of Valsalva for attenuating needle puncture pain in first time nonremunerated voluntary plateletpheresis donors: A prospective, randomized controlled trial. Asian J Transfus Sci 2021; 15:68-74. [PMID: 34349460 PMCID: PMC8294442 DOI: 10.4103/ajts.ajts_95_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/01/2020] [Accepted: 11/22/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: Plateletpheresis is generally safe but may have adverse reactions. Adverse reactions can negatively influence donor recruitment and retention. Valsalva is a proven method of attenuating pain caused by venipuncture. AIMS: The aim was to evaluate the efficacy of the Valsalva maneuver on the attenuation of needle pain and donor anxiety. SETTINGS AND DESIGN: This prospective randomized controlled trial was conducted between November 2015 and April 2016 at the Department of Transfusion Medicine. SUBJECTS AND METHODS: One-hundred and sixty consecutive donors were grouped into control group (C) and Valsalva group (V) each of sample size 80. The Valsalva group performed a Valsalva maneuver and control did nothing before the venipuncture. Anxiety and pain were scored using a 10 cm visual analog scale (VAS). Severity was graded as VAS = 0 defines no pain and anxiety, VAS = 1–3 as mild pain and anxiety, VAS = 4–6 as moderate pain and anxiety, VAS = 7–9 as severe pain and anxiety, whereas VAS = 10 denotes extreme pain and anxiety. STATISTICAL ANALYSIS: Statistical Package for Social Sciences, version 23 was used for analysis. Independent samples t-test/Mann–Whitney U-test was used to compare between treatment and control group, whereas the Wilcoxon signed-rank test was used to test the difference between pre- and postobservations. RESULTS: In the Valsalva group, post-Valsalva anxiety levels were significantly reduced to (1 [0–2]) from their pre-Valsalva values of (2 [0–3]); (P < 0.001). Pain was significantly lower (2[1-2]) in Valsalva group compared to control (4[2–5]); (P < 0.001). CONCLUSIONS: Valsalva reduced both severity of venipuncture pain and anxiety. Valsalva can be performed by donors as it is an easy, painless, and nonpharmacological method of pain and anxiety attenuation.
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Affiliation(s)
- Anubha Srivastava
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Kumar
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anil Agarwal
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Dheeraj Khetan
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rahul Katharia
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Prabhaker Mishra
- Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shikha Khati
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sujeet Gautam
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Khuba Sandeep
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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13
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Kamar S, Hallit S, Chamandi S. Vasovagal syncope related to pain procedures in a pain clinic at a tertiary Lebanese hospital between 2016 and 2019. BMC Res Notes 2021; 14:133. [PMID: 33849656 PMCID: PMC8042938 DOI: 10.1186/s13104-021-05541-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/23/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives Our study focuses on evaluating the factors associated with vasovagal syncope (VVS) when having a pain procedure at the pain clinic as well as showing variation in vital signs associated with fainting across different periods of the procedure (before, during and after).A retrospective case control study was conducted in a university hospital in Lebanon (CHU-NDS) on adult Lebanese patients with data taken from the archives covering a 4 year period (2016–2019). Results The multivariable analysis showed that a higher systolic blood pressure per-procedure was significantly associated with lower odds of having vasovagal syncope. An adequate dose of a vasopressor like ephedrine can be used to prevent a vasovagal event from happening. In our study the blood pressure component was more significant than the heart rate component which stayed in the normal range limit in the three different periods of procedure. Cases having a pain procedure for the first time represent 59.6% of the occurrence of VVS. Vasovagal syncope is a complication that can be prevented in high risk patients. Our study suggests taking preventive measures for VVS for patients with first time infiltration status especially if appearing in an anxious state.
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Affiliation(s)
- Sara Kamar
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.
| | - Souheil Chamandi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Department of Anesthesiology, Notre Dame des Secours University Hospital, Byblos, Lebanon
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14
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Davies J, MacDonald L, Sivakumar B, Carty C, Whiting D, Graham D. Prospective analysis of syncope/pre-syncope in a tertiary paediatric orthopaedic fracture outpatient clinic. ANZ J Surg 2021; 91:668-672. [PMID: 33605034 DOI: 10.1111/ans.16664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The incidence of vasovagal syncope (VVS) precipitated by medical procedures such as blood donation is quoted as between 0.13% and 4.17%. Vasovagal events have been observed to occur following cast removal at our paediatric orthopaedic clinic; however, there is no available information in the existing literature regarding incidence or risk factors. This study aims to identify the incidence and demographic traits of patients experiencing syncopal events following cast removal. METHODS Over a 12-month period, paediatric patients experiencing a syncopal or pre-syncopal event during an outpatient appointment for cast removal were prospectively enrolled into the study. Basic demographic data were recorded, as well as injury and procedure details and a description of the event. Statistical analysis as well as calculation of incidence of vasovagal events were performed. RESULTS A total of 6078 patients presented for cast removal in the 12-month period. Twenty syncopal or pre-syncopal events were recorded. Incidence was calculated as 0.32%. Mean patient age was 10.8 years. Male : female ratio was 2.3:1. Mean body mass index (BMI) was 20.08, with a trend for higher prevalence of males under the 50th BMI percentile-for-age. The mean time post-injury was 31.4 days. Ninety-five percent of patients were being treated for an upper limb injury and 30% had injuries that had been treated surgically. There were no associated secondary complications or injuries. CONCLUSIONS Incidence of VVS following cast removal is comparable to the values quoted in literature for other medical procedures. Demographic data of our cohort suggested that those who experienced VVS were predominantly young males of lower-than-average BMI.
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Affiliation(s)
- Jonathan Davies
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Leigh MacDonald
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Brahman Sivakumar
- Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Australian Research Collaboration on Hands, Gold Coast, Queensland, Australia
| | - Christopher Carty
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Donal Whiting
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - David Graham
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Australian Research Collaboration on Hands, Gold Coast, Queensland, Australia
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15
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Radovčić MK, Ljubičić J, Očić T, Jukić I, Vuk T. Blood collection failures from a blood establishment perspective. Transfus Med 2021; 31:88-93. [PMID: 33458900 DOI: 10.1111/tme.12762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/04/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The objective of this study was to show experience of the Croatian Institute of Transfusion Medicine in monitoring and analysing collection failures caused by the venepuncture technique or occurred as a result of adverse reactions and complications experienced by donors during donation. BACKGROUND Collection failures represent one of the leading nonconformities in blood establishments. Apart from being a negative motivating factor for blood donors, they also affect the blood components supply and have a negative financial impact. METHODS Nonconformity records referring to collection failures were analysed retrospectively over a 6-year period (2013-2018) with regard to their frequency, causes, donor characteristics (age, gender, number of donations), place of occurrence (blood establishment, mobile sessions) and trends during the analysed period. RESULTS A total of 5166 collection failures out of 618 251 donations (0.84%) were recorded during the analysed period. The leading cause was haematoma at puncture site (1676, i.e., 32.4%). Collection failures which are primarily attributed to the venepuncture technique or vein selection accounted for 91% of all cases, whereas collection failures which occurred as a result of discontinued punctures due to adverse reactions in donors accounted for 9% of all cases. A much higher frequency of all collection failure types was recorded in female donors, whereas younger donors experienced adverse reactions more frequently (median age of 24). CONCLUSION The analysis and monitoring frequency of collection failures play an important role in planning of staff training activities, work organisation and timely implementation of corrective actions.
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Affiliation(s)
| | | | - Tihomir Očić
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Irena Jukić
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Tomislav Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
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16
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Goldman M, Townsend M, Magnussen K, Lozano M, Nissen-Meyer LS, Lee CK, Leung JNS, Takanashi M, McKay J, Kvist M, Robitaille N, Deschênes J, Di Angelantonio E, McMahon A, Roberts D, Maghsudlu M, Castrén J, Tiberghien P, Woimant G, Morel P, Kamel H, Bravo M, Shinhar E, Gendelman V, Raz H, Wendel S, Fachini R, Quee F, van den Hurk K, Wiersum J, Grima K, Speedy J, Bruun M, Dunbar N. Vox Sanguinis International Forum on Mitigation Strategies to Prevent Faint and Pre-faint Adverse Reactions in Whole Blood Donors: Summary. Vox Sang 2020; 116:351-359. [PMID: 33245787 DOI: 10.1111/vox.13037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, ON, Canada
| | | | - Karin Magnussen
- Immunology & Transfusion Medicine, Innlandet Hospital Trust, Lillehammer, Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nancy Dunbar
- Blood Bank, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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17
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Townsend M, Buccino T, Katz L. Evaluation of donor informed consents and associated predonationeducational materials in the United Statesand Canada: variability in elements of consent and measures of readability and reading burden. Transfusion 2020; 60:1747-1755. [DOI: 10.1111/trf.15867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Louis Katz
- Mississippi Valley Regional Blood Center Davenport Iowa USA
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18
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Namba N, Ishimaru F, Kondo G, Hashizume T, Kunii N, Shibata R, Sawamura Y, Kato T. Syncopal-type reactions tend to be delayed and result in falls among elderly blood donors. Vox Sang 2020; 116:36-41. [PMID: 32856735 DOI: 10.1111/vox.12981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Delayed syncopal-type complications are infrequent among blood donors, but sometimes have critical consequences, such as severe injury. We retrospectively investigated the characteristics of donors with delayed syncopal-type complications or falls. STUDY DESIGN AND METHODS We defined a delayed reaction (DR) as syncopal-type complications occurring >20 min after needle removal. Subjects were stratified by sex, age, estimated blood volume (EBV), body mass index (BMI) and frequency of donation. Multiple logistic regression analysis and propensity score weighted M estimation were performed to evaluate the covariate-adjusted risk of syncopal DRs among donors giving 400 ml of whole blood (WB). The DR rate was calculated as the number of DRs divided by the number of all syncopal-type reactions after needle removal. The risk of falls was assessed similarly. Donors who discontinued before completing phlebotomy (donation of 400 ml) were excluded. RESULTS Among 3818 syncopal-type reactions after needle removal, there were 359 DRs and 93 falls. Elderly donors and female donors with syncopal-type reactions had a significantly higher risk of DRs (P for trend < 0·001). Elderly donors with syncopal-type reactions also had a higher risk of falls (P for trend < 0·001). Among all donors with syncopal-type reactions, the risk of DRs or falls was not correlated with EBV, BMI or donation frequency. CONCLUSION In female donors and elderly donors (donating 400 ml of WB), syncopal-type reactions tended to be delayed. Elderly donors with syncopal-type reactions had a significantly higher risk of falls.
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Affiliation(s)
- Noriko Namba
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | | | - Gaku Kondo
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | | | - Noriko Kunii
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | - Reiko Shibata
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
| | | | - Tsuneo Kato
- Japanese Red Cross Tokyo Metropolitan Blood Center, Tokyo, Japan
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19
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Hashizume T, Ishimaru F, Kondo G, Namba N, Miura Y, Aota S, Nishitani Y, Kunii N, Misawa H, Shibata R, Sawamura Y, Matsuzaki K, Nakajima K, Kato T. Comfortable environment for blood donation lowers the rate of vasovagal reactions. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/voxs.12540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tatsuma Hashizume
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Fumihiko Ishimaru
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Gaku Kondo
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Noriko Namba
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Yoshiko Miura
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Seiko Aota
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Yumiko Nishitani
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Noriko Kunii
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Hiromi Misawa
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Reiko Shibata
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Yoshihiro Sawamura
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Koji Matsuzaki
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Kazunori Nakajima
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
| | - Tsuneo Kato
- Japanese Red Cross Tokyo Metropolitan Blood Center Shinjuku‐Ku Tokyo Japan
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20
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Wang HH, Chen PM, Lin CL, Jau RC, Hsiao SM, Ko JL. Joint effects of risk factors on adverse events associated with adult blood donations. Medicine (Baltimore) 2019; 98:e17758. [PMID: 31689834 PMCID: PMC6946510 DOI: 10.1097/md.0000000000017758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The process for blood donation is considered safe, but some adverse events have been reported. Risk factors for adverse events were assessed in this study.A retrospective case-control study was conducted to investigate the risk factors for adverse events after blood donation between 2010 and 2013. Variables such as gender, age, body mass index (BMI), donation status, donation volume, donation site, pre-donation systolic blood pressure (SBP), and pre-donation diastolic blood pressure were compared between donors with and without adverse events. Multiple logistic regression analysis was performed to assess the joint effects of age, gender, and donation status on adverse events.The incidence of adverse events among adult blood donations was 1287/1,253,678 (0.1%). On multivariate logistic regression analysis, blood donors aged <35 years (odds ratio [OR], 2.99, 95% confidence interval [CI], 2.57-3.48), of female gender (OR, 3.30, 95% CI, 2.62-4.15), and with first-time donor status (OR, 6.40, 95% CI, 5.17-7.93), donation of 500 mL (OR, 2.22, 95% CI, 1.83-2.69), predonation SBP <124 mm Hg (OR, 1.25, 95% CI,1.05-1.48) and BMI <24 kg/m (OR, 1.67, 95% CI, 1.42-1.96) were associated with increased likelihood of adverse event. Further analysis with joint effects method revealed that first-time female donors aged <35 years are associated with the highest odds of adverse events when compared with repeat male donors aged ≧35 years (OR, 100.57, 95% CI, 48.45-208.75).The findings of our study should prove useful in identifying donors at risk and planning appropriate strategies for the prevention of adverse effects.
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Affiliation(s)
- Hsuan-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung
- Taichung Blood Center, Taiwan Blood Services Foundation
| | - Po-Ming Chen
- Institute of Medicine, Chung Shan Medical University, Taichung
| | - Chi-Ling Lin
- Taichung Blood Center, Taiwan Blood Services Foundation
| | | | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan
| | - Jiunn-Liang Ko
- Institute of Medicine, Chung Shan Medical University, Taichung
- Department of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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21
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Masser B, Ferguson E, Merz EM, Williams L. Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood. Transfus Med Hemother 2019; 47:175-185. [PMID: 32355478 DOI: 10.1159/000501917] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/03/2019] [Indexed: 11/19/2022] Open
Abstract
Background Research on the recruitment and retention of blood donors has typically drawn on a homogeneous set of descriptive theories, viewing the decision to become and remain a donor as the outcome of affectively cold, planned, and rational decision-making by the individual. While this approach provides insight into how our donors think about blood donation, it is limited and has not translated into a suite of effective interventions. In this review, we set out to explore how a broader consideration of the influences on donor decision-making, in terms of affect, memory, and the context in which donation takes place, may yield benefit in the way we approach donor recruitment and retention. Summary Drawing on emerging research, we argue for the importance of considering the implications of both the positive and the negative emotions that donors experience and we argue for the importance of directly targeting affect in interventions to recruit nondonors. Next, we focus on the reconstructed nature of memory and the factors that influence what we remember about an event. We discuss how these processes may impact the retention of donors and the potential to intervene to enhance donors' recollections of their experiences. Finally, we discuss how our focus on the individual has led us to neglect the influence of the context in which donation takes place on donor behavior. We argue that the amassing of comprehensive large data sets detailing both the characteristics of the individuals and the context of their giving will ultimately allow for the more effective deployment of resources to improve recruitment and retention. Key Messages In suggesting these directions for future research, our want is to move beyond the ways in which we have traditionally described blood donation behavior with the aim of improving our theorizing about donors while improving the translational value of our research.
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Affiliation(s)
- Barbara Masser
- School of Psychology, The University of Queensland, St. Lucia, Queensland, Australia.,Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Eva-Maria Merz
- Department of Donor Medicine, Sanquin Research, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lisa Williams
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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22
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Donald SJ, McIntyre WF, Dingwall O, Hiebert B, Ponnampalam A, Seifer CM. Is donating blood for the faint of heart? a systematic review of predictors of syncope in whole blood donors. Transfusion 2019; 59:2865-2869. [DOI: 10.1111/trf.15442] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 06/09/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Scott J. Donald
- Section of Cardiology, Department of Internal Medicine, Max Rady College of MedicineRady Faculty of Health Sciences, University of Manitoba Winnipeg Canada
| | | | - Orvie Dingwall
- Neil John Maclean Health Sciences Library, University of Manitoba Winnipeg Canada
| | - Brett Hiebert
- Cardiac Sciences Program, St Boniface Hospital Winnipeg Canada
| | - Arjuna Ponnampalam
- Section of Hematology, Department of Internal MedicineMax Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Winnipeg Manitoba Canada
| | - Colette M. Seifer
- Section of Cardiology, Department of Internal Medicine, Max Rady College of MedicineRady Faculty of Health Sciences, University of Manitoba Winnipeg Canada
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23
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Lerner AJ, Wassermann EM, Tamir DI. Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics. Clin Neurophysiol 2019; 130:1409-1416. [PMID: 31104898 PMCID: PMC7274462 DOI: 10.1016/j.clinph.2019.03.016] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 02/14/2019] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
Objective: Transcranial magnetic stimulation (TMS) can cause seizures in healthy individuals and patients. However, the rate at which this occurs is unknown. We estimated the risk of seizure and other adverse events with TMS. Methods: We surveyed laboratories and clinics about seizures and other events observed between 2012 and 2016 (inclusive). Respondents (N = 174) reported an estimated 318,560 TMS sessions. Results: Twenty-four seizures were reported (.08/1000 sessions). TMS delivered within published guidelines to subjects without recognized risk factors caused 4 seizures (<.02/1000 sessions). High-frequency (>1 Hz) rTMS delivered within published guidelines to individuals without known risk factors was no more likely to cause seizures than low-frequency and single/paired-pulse TMS. Subject risk factors (e.g., brain lesions and epilepsy) increased seizure risk substantially. Seizures appeared more common when safety guidelines were exceeded. Seizures were most likely to occur within the first few exposures to TMS. Conclusions: TMS delivered within published guidelines to individuals without risk factors appears to cause fewer than 1 seizure per 60,000 sessions. The assumption that repetitive TMS is riskier than single and paired pulses under these conditions should be reevaluated. Significance: This information should help laboratories, clinics, and regulatory authorities form updated safety policies for TMS.
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Affiliation(s)
- Adam J Lerner
- Center for Bioethics, New York University, New York, NY 10003, USA.
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
| | - Diana I Tamir
- Department of Psychology, Princeton University, Princeton, NJ 08544, USA; Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08544, USA
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24
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Davison TE, Masser BM, Thorpe R. Growing evidence supports healthy older people continuing to donate blood into later life. Transfusion 2019; 59:1166-1170. [DOI: 10.1111/trf.15237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Tanya E. Davison
- Clinical Services and Research; Australian Red Cross Blood Service; Melbourne Australia
| | - Barbara M. Masser
- Clinical Services and Research; Australian Red Cross Blood Service; Melbourne Australia
- School of Psychology; The University of Queensland; Brisbane Australia
| | - Rachel Thorpe
- Clinical Services and Research; Australian Red Cross Blood Service; Melbourne Australia
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25
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Wood EM, Ang AL, Bisht A, Bolton-Maggs PH, Bokhorst AG, Flesland O, Land K, Wiersum-Osselton JC, Schipperus MR, Tiberghien P, Whitaker BI. International haemovigilance: what have we learned and what do we need to do next? Transfus Med 2019; 29:221-230. [PMID: 30729612 DOI: 10.1111/tme.12582] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/05/2018] [Accepted: 01/12/2019] [Indexed: 02/06/2023]
Abstract
The International Haemovigilance Network (IHN) defines haemovigilance as 'a set of surveillance procedures covering the whole transfusion chain (from the collection of blood and its components to the follow-up of recipients), intended to collect and assess information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products, and to prevent their occurrence or recurrence'. IHN, the International Society of Blood Transfusion and World Health Organization work together to support both developing and established haemovigilance systems. Haemovigilance systems provide valuable data on a range of adverse events related to blood donation and clinical transfusion, from donor syncopal events to transfusion-transmitted infections, immunological complications and the impact of human errors. Harmonised definitions for most adverse reactions have been developed and validated internationally. Definitions of pulmonary complications are again under review. Haemovigilance data have resulted in changes in policy, products and practice, and can complement and inform clinical audit and research, leading to improved blood donor safety, optimised product use and better clinical outcomes after transfusion. However, more work is needed. Not all countries have haemovigilance systems in place. More robust data and careful analysis are required to improve the understanding of the causes, occurrence and clinical outcomes of these events. Wider dissemination of results will facilitate health policy development internationally, and implementation of haemovigilance recommendations will support further important progress in blood safety.
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Affiliation(s)
- E M Wood
- Transfusion Research Unit, Monash University, Melbourne, Victoria, Australia.,Department of Clinical Haematology, Monash Health, Melbourne, Victoria, Australia
| | - A L Ang
- Blood Services Group, Health Sciences Authority, Singapore.,Department of Haematology, Singapore General Hospital, Singapore
| | - A Bisht
- Haemovigilance Programme of India, National Institute of Biologicals, Ministry of Health & Family Welfare, Noida, India
| | - P H Bolton-Maggs
- Serious Hazards of Transfusion, Manchester, UK.,University of Manchester, Manchester, UK
| | - A G Bokhorst
- Transfusion and Transplantation Reactions in Patients (TRIP), National Haemovigilance and Biovigilance Office, Leiden, The Netherlands
| | - O Flesland
- Norwegian Directorate of Health, Oslo, Norway
| | - K Land
- Blood Systems Inc., Tempe, Arizona, USA.,Department of Pathology, University of Texas Health Science Center, San Antonio, Texas, USA
| | - J C Wiersum-Osselton
- Transfusion and Transplantation Reactions in Patients (TRIP), National Haemovigilance and Biovigilance Office, Leiden, The Netherlands
| | - M R Schipperus
- Transfusion and Transplantation Reactions in Patients (TRIP), National Haemovigilance and Biovigilance Office, Leiden, The Netherlands.,Department of Haematology, Haga Teaching Hospital, The Hague, The Netherlands
| | - P Tiberghien
- Etablissement Français du Sang, La Plaine St Denis, France.,Université de Franche-Comté, Inserm, EFS, UMR 1098, Besançon, France
| | - B I Whitaker
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Review US Food & Drug Administration, Silver Spring, Maryland, USA
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26
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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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27
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Land KJ, Townsend M, Goldman M, Whitaker BI, Perez GE, Wiersum-Osselton JC. International validation of harmonized definitions for complications of blood donations. Transfusion 2018; 58:2589-2595. [DOI: 10.1111/trf.14948] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Kevin J. Land
- Blood Systems, Inc.; San Antonio Texas
- UT Health Science Center at San Antonio, Department of Pathology; San Antonio Texas
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28
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Esplendori GF. Adverse reactions to whole blood donation, basic human needs and nursing diagnoses: a reflection. Rev Esc Enferm USP 2018; 51:e03284. [DOI: 10.1590/s1980-220x2017005003284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/29/2017] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT A theoretical-Reflective study with the objective to reflect on human needs regarding the imbalance of whole blood donors considering adverse reactions to the donation, and the existing nursing diagnoses that best meet the imbalance needs. The following needs were pointed out according to the signs and symptoms of adverse reactions and based on the Theory of Basic Human Needs: skin and tissue integrity, emotional security, pain perception, body mechanics, oxygenation, physical integrity, physical comfort, elimination, neurological, electrolytic and vascular regulation. By observing NANDA International’s Definitions and Classifications, adaptations to the existing nursing diagnoses and suggestions for new headings have been proposed. We conclude that some of the needs are interrelated, such as vascular regulation, oxygenation and physical integrity. Thus, more contextualized nursing diagnoses related to the needs of whole blood donors are needed, given the specific nature of the situation generating imbalances such as: ineffective systemic vascular regulation characterized by self-reported dizziness, cutaneous pallor and arterial hypotension related to vasovagal reaction.
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29
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Thijsen A, Masser B. Vasovagal reactions in blood donors: risks, prevention and management. Transfus Med 2017; 29 Suppl 1:13-22. [DOI: 10.1111/tme.12488] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/19/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Thijsen
- Clinical Services and ResearchAustralian Red Cross Blood Service Sydney New South Wales Australia
| | - B. Masser
- Clinical Services and ResearchAustralian Red Cross Blood Service Brisbane Queensland Australia
- School of PsychologyThe University of Queensland Brisbane Queensland Australia
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30
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Kemper AR, Barnett ED, Walter EB, Hornik C, Pierre-Joseph N, Broder KR, Silverstein M, Harrington T. Drinking Water to Prevent Postvaccination Presyncope in Adolescents: A Randomized Trial. Pediatrics 2017; 140:peds.2017-0508. [PMID: 29061871 PMCID: PMC6075677 DOI: 10.1542/peds.2017-0508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Postvaccination syncope can cause injury. Drinking water prephlebotomy increases peripheral vascular tone, decreasing risk of blood-donation presyncope and syncope. This study evaluated whether drinking water prevaccination reduces postvaccination presyncope, a potential syncope precursor. METHODS We conducted a randomized trial of subjects aged 11 to 21 years receiving ≥1 intramuscular vaccine in primary care clinics. Intervention subjects were encouraged to drink 500 mL of water, with vaccination recommended 10 to 60 minutes later. Control subjects received usual care. Presyncope symptoms were assessed with a 12-item survey during the 20-minutes postvaccination. Symptoms were classified with a primary cutoff sensitive for presyncope, and a secondary, more restrictive cutoff requiring greater symptoms. Results were adjusted for clustering by recruitment center. RESULTS There were 906 subjects randomly assigned to the control group and 901 subjects randomly assigned to the intervention group. None had syncope. Presyncope occurred in 36.2% of subjects by using the primary definition, and in 8.0% of subjects by using the restrictive definition. There were no significant differences in presyncope by intervention group for the primary (1-sided test, P = .24) or restrictive outcome (1-sided test, P = .17). Among intervention subjects vaccinated within 10 to 60 minutes after drinking all 500 mL of water (n = 519), no reduction in presyncope was observed for the primary or restrictive outcome (1-sided tests, P = .13, P = .17). In multivariable regression analysis, presyncope was associated with younger age, history of passing out or nearly passing out after a shot or blood draw, prevaccination anxiety, receiving >1 injected vaccine, and greater postvaccination pain. CONCLUSIONS Drinking water before vaccination did not prevent postvaccination presyncope. Predictors of postvaccination presyncope suggest opportunities for presyncope and syncope prevention interventions.
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Affiliation(s)
- Alex R. Kemper
- Division of Ambulatory Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio
| | - Elizabeth D. Barnett
- Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts
| | | | - Christoph Hornik
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Natalie Pierre-Joseph
- Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts
| | - Karen R. Broder
- Division of Healthcare Quality Promotion, Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael Silverstein
- Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts
| | - Theresa Harrington
- Division of Healthcare Quality Promotion, Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
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31
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Seheult JN, Lund ME, Yazer MH, Titlestad K. Factors associated with vasovagal reactions in apheresis plasma and whole blood donors: a statistical-epidemiological study in a European donor cohort. Blood Res 2016; 51:293-296. [PMID: 28090497 PMCID: PMC5234239 DOI: 10.5045/br.2016.51.4.293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 11/20/2016] [Accepted: 11/23/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jansen N Seheult
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Merete Eis Lund
- Department of Clinical Immunology, Odense University Hospital, Odense C, Denmark
| | - Mark H Yazer
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.; Department of Clinical Immunology, Odense University Hospital, Odense C, Denmark.; The Institute for Transfusion Medicine, Pittsburgh, PA, USA
| | - Kjell Titlestad
- Department of Clinical Immunology, Odense University Hospital, Odense C, Denmark
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32
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Fu Q, Levine BD. Syncope prevention in blood donors: when to do what? Transfusion 2016; 56:2399-2402. [DOI: 10.1111/trf.13775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Qi Fu
- Institute for Exercise and Environmental Medicine; Texas Health Presbyterian Hospital Dallas; Dallas TX
| | - Benjamin D. Levine
- Institute for Exercise and Environmental Medicine; Texas Health Presbyterian Hospital Dallas; Dallas TX
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33
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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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34
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Narbey D, Fillet AM, Jbilou S, Tiberghien P, Djoudi R. Case-control study of immediate and delayed vasovagal reactions in blood donors. Vox Sang 2016; 111:257-265. [DOI: 10.1111/vox.12418] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 04/02/2016] [Accepted: 04/24/2016] [Indexed: 11/27/2022]
Affiliation(s)
- D. Narbey
- Medical Department; Etablissement Français du Sang; La Plaine Saint Denis France
| | - A.-M. Fillet
- Medical Department; Etablissement Français du Sang; La Plaine Saint Denis France
| | - S. Jbilou
- Medical Department; Etablissement Français du Sang; La Plaine Saint Denis France
| | - P. Tiberghien
- Medical Department; Etablissement Français du Sang; La Plaine Saint Denis France
- UMR 1098; INSERM; Université Franche-Comté; Etablissement Français du Sang; Besançon France
| | - R. Djoudi
- Medical Department; Etablissement Français du Sang; La Plaine Saint Denis France
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35
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Fisher SA, Allen D, Dorée C, Naylor J, Di Angelantonio E, Roberts DJ. Interventions to reduce vasovagal reactions in blood donors: a systematic review and meta-analysis. Transfus Med 2016; 26:15-33. [DOI: 10.1111/tme.12275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/16/2015] [Accepted: 12/24/2015] [Indexed: 11/30/2022]
Affiliation(s)
- S. A. Fisher
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine; University of Oxford; Oxford UK
| | - D. Allen
- Blood Research Group; NHS Blood and Transplant; Oxford UK
| | - C. Dorée
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine; University of Oxford; Oxford UK
| | - J. Naylor
- Blood Supply; NHS Blood and Transplant; Leeds UK
| | - E. Di Angelantonio
- Department of Public Health and Primary Care; University of Cambridge; Cambridge UK
| | - D. J. Roberts
- Systematic Review Initiative; NHS Blood and Transplant; Oxford UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine; University of Oxford; Oxford UK
- Blood Research Group; NHS Blood and Transplant; Oxford UK
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36
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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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37
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First-time whole blood donation: A critical step for donor safety and retention on first three donations. Transfus Clin Biol 2015; 22:312-7. [DOI: 10.1016/j.tracli.2015.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/12/2015] [Indexed: 11/24/2022]
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38
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Goldman M, Land K, Robillard P, Wiersum-Osselton J. Development of standard definitions for surveillance of complications related to blood donation. Vox Sang 2015; 110:185-8. [PMID: 26361365 DOI: 10.1111/vox.12323] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 11/28/2022]
Abstract
Standard definitions of donor reactions allow each blood establishment to monitor donor adverse events and compare with other organizations to develop best practices. The ISBT Haemovigilance Working Party leads a multi-organizational effort to update the 2008 ISBT standard for surveillance of complications related to blood donation. Revised definitions have been developed and endorsed by the ISBT, AABB, International Haemovigilance Network (IHN) and other international organizations.
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Affiliation(s)
- M Goldman
- Canadian Blood Services, Ottawa, ON, Canada
| | - K Land
- Blood Systems Inc., Scottsdale, AZ, USA
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39
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France CR, France JL, Frame-Brown TA, Venable GA, Menitove JE. Fear of blood draw and total draw time combine to predict vasovagal reactions among whole blood donors. Transfusion 2015; 56:179-85. [DOI: 10.1111/trf.13264] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/03/2015] [Accepted: 07/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Geri A. Venable
- Community Blood Center of Greater Kansas City; Kansas City Missouri
| | - Jay E. Menitove
- Community Blood Center of Greater Kansas City; Kansas City Missouri
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40
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Spitalnik SL, Triulzi D, Devine DV, Dzik WH, Eder AF, Gernsheimer T, Josephson CD, Kor DJ, Luban NLC, Roubinian NH, Mondoro T, Welniak LA, Zou S, Glynn S. 2015 proceedings of the National Heart, Lung, and Blood Institute's State of the Science in Transfusion Medicine symposium. Transfusion 2015; 55:2282-90. [PMID: 26260861 DOI: 10.1111/trf.13250] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 06/30/2015] [Accepted: 06/30/2015] [Indexed: 01/28/2023]
Abstract
On March 25 and 26, 2015, the National Heart, Lung, and Blood Institute sponsored a meeting on the State of the Science in Transfusion Medicine on the National Institutes of Health (NIH) campus in Bethesda, Maryland, which was attended by a diverse group of 330 registrants. The meeting's goal was to identify important research questions that could be answered in the next 5 to 10 years and which would have the potential to transform the clinical practice of transfusion medicine. These questions could be addressed by basic, translational, and/or clinical research studies and were focused on four areas: the three "classical" transfusion products (i.e., red blood cells, platelets, and plasma) and blood donor issues. Before the meeting, four working groups, one for each area, prepared five major questions for discussion along with a list of five to 10 additional questions for consideration. At the meeting itself, all of these questions, and others, were discussed in keynote lectures, small-group breakout sessions, and large-group sessions with open discourse involving all meeting attendees. In addition to the final lists of questions, provided herein, the meeting attendees identified multiple overarching, cross-cutting themes that addressed issues common to all four areas; the latter are also provided. It is anticipated that addressing these scientific priorities, with careful attention to the overarching themes, will inform funding priorities developed by the NIH and provide a solid research platform for transforming the future practice of transfusion medicine.
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Affiliation(s)
- Steven L Spitalnik
- Department of Pathology & Cell Biology, Columbia University Medical Center-New York Presbyterian Hospital, New York, New York
| | - Darrell Triulzi
- Institute for Transfusion Medicine and Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dana V Devine
- Canadian Blood Services and the Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Walter H Dzik
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Anne F Eder
- National Headquarters, American Red Cross, Rockville, Maryland
| | - Terry Gernsheimer
- Department of Medicine, University of Washington, Seattle, Washington
| | - Cassandra D Josephson
- Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Daryl J Kor
- Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Naomi L C Luban
- Division of Laboratory Medicine, Center for Cancer and Blood Disease, Children's National Health System, and the Department of Pediatrics, George Washington University School of Medicine, Washington, DC
| | - Nareg H Roubinian
- Blood Systems Research Institute, and the Department of Laboratory Medicine, University of California, San Francisco, California
| | - Traci Mondoro
- Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Lisbeth A Welniak
- Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Shimian Zou
- Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Simone Glynn
- Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland
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Abstract
BACKGROUND Reports on unexpected events (UEs) during blood donation (BD) inadequately consider the role of technical UEs. METHODS Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations, and UEs from January 1, 2008 to June 30, 2011. RESULTS 6,605 UEs were observed during 166,650 BDs from 57,622 donors for a corrected incidence of 4.30% (0.66% local, 1.59% systemic, 2.04% technical UEs). 2.96% of BDs were accompanied by one UE and 0.45% by >1 UE (2-4). 6.3% of donors donating blood for their first time, 3.5% of those giving blood for their second time, and 1.9% of donors giving their third or more BD experienced UEs. Most common UEs were: discontinued collections due to venous access problems, repeated venipuncture, and small hematomas. Severe circulatory UEs occurred at a rate of 16 per 100,000 BDs. CONCLUSIONS Technical UEs were common during BD. UEs accompanied first and second donations significantly more often than subsequent donations.
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42
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Riga A, Sapey T, Bacanu M, Py JY, Dehaut F. Blood donors – Serious adverse reactions (SAR) 2010–2014 EFS Châteauroux, France. Transfus Clin Biol 2015; 22:62-5. [DOI: 10.1016/j.tracli.2015.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
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43
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Burkhardt T, Dimanski B, Karl R, Sievert U, Karl A, Hübler C, Tonn T, Sopvinik I, Ertl H, Moog R. Donor vigilance data of a blood transfusion service: A multicenter analysis. Transfus Apher Sci 2015; 53:180-4. [PMID: 26074050 DOI: 10.1016/j.transci.2015.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/10/2015] [Accepted: 03/13/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Donor vigilance is an important part of the quality management system of blood transfusion services. The evaluation of donor side effects helps to improve the donation process and donor compliance. The aim of the present study was to evaluate donor vigilance data in whole blood and plasmapheresis donors of a blood donor service. MATERIALS AND METHODS Donors fulfilling current national and European eligibility criteria underwent whole blood and plasmapheresis donation (PCS and MCS+ (Haemonetics, Braintree, USA), A 200 (Fenwal, Round Lake, USA). Whole blood was collected at fixed and mobile sites while plasmaphereses were performed at 8 plasma centers. From 2011 to 2013 donor information was provided for gender, age, body weight, height, first and repeat donation. Donors were monitored for venipuncture and circulatory associated side effects. RESULTS The total incidences of adverse events were 5004 (0.56%) in repeat donors and 2111 (2.78%) in first time donors for whole blood donation and 3323 (1.01%) and 514 (7.96%) for plasmaphereses, respectively. Circulatory associated events were 2679 (0.30%) for whole blood donation and 1624 (0.49%) for plasmaphereses. CONCLUSION Our donor vigilance data of a blood transfusion service show that whole blood and plasmapheresis are safe with low incidences of adverse events. Repeat donation and age are predictors for low rates of adverse events. On the other hand, first time donation and female gender were associated with higher incidences of adverse events.
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Affiliation(s)
- T Burkhardt
- German Red Cross Blood Donor Service North-East, Institute Plauen, Germany
| | | | - R Karl
- Institute Berlin, Germany; Institute Potsdam, Germany
| | | | - A Karl
- German Red Cross Blood Donor Service North-East, Institute Plauen, Germany; Institute Chemnitz, Germany
| | | | - T Tonn
- Institute Dresden, Germany; Medical Faculty Carl Gustav Carus Technische Universitaet Dresden, Germany
| | | | - H Ertl
- German Red Cross Blood Donor Service North-East, Institute Plauen, Germany
| | - R Moog
- Institute Cottbus, Germany.
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Factors associated with psychological and physiological stress reactions to blood donation: a systematic review of the literature. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:354-62. [PMID: 25761310 DOI: 10.2450/2015.0139-14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 12/02/2014] [Indexed: 12/22/2022]
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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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Wood EM, Stevenson L, Bielby L, Wiersum-Osselton JC. Haemovigilance: concepts and frameworks. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/voxs.12105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E. M. Wood
- Transfusion Research Unit; Monash University; Melbourne Vic. Australia
- Department of Health Victoria; Serious Transfusion Incident Reporting (STIR) system; Blood Matters Programme; Melbourne Vic. Australia
| | - L. Stevenson
- Department of Health Victoria; Serious Transfusion Incident Reporting (STIR) system; Blood Matters Programme; Melbourne Vic. Australia
| | - L. Bielby
- Department of Health Victoria; Serious Transfusion Incident Reporting (STIR) system; Blood Matters Programme; Melbourne Vic. Australia
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Wiersum-Osselton JC, Wood E, Bolton-Maggs PHB, Schipperus MR. Definitions in haemovigilance: guiding principles and current state of development of international reference definitions. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/voxs.12091] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- J. C. Wiersum-Osselton
- TRIP National Hemovigilance and Biovigilance Office; The Hague the Netherlands
- Sanquin Blood Supply; Donor Services Unit; Leiden the Netherlands
| | - E. Wood
- Transfusion Research Unit; Monash University; Melbourne Vic. Australia
- Serious Transfusion Incident Reporting (STIR) program, Blood Matters; Melbourne Vic. Australia
| | | | - M. R. Schipperus
- TRIP National Hemovigilance and Biovigilance Office; The Hague the Netherlands
- Haga Teaching Hospital; The Hague the Netherlands
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48
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Newman BH. Management of young blood donors. ACTA ACUST UNITED AC 2014; 41:284-95. [PMID: 25254024 DOI: 10.1159/000364849] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/24/2014] [Indexed: 11/19/2022]
Abstract
The emphasis on high-school blood drives and acceptance of 16-year-old blood donors led to more research on physiologic and psychological ways to decrease vasovagal reaction rates in young blood donors and to increase donor retention. Research on how to accomplish this has been advantageous for the blood collection industry and blood donors. This review discussed the current situation and what can be done psychologically, physiologically, and via process improvements to decrease vasovagal reaction rates and increase donor retention. The donation process can be significantly improved. Future interventions may include more dietary salt, a shorter muscle tension program to make it more feasible, recommendations for post-donation muscle tension / squatting / laying down for lightheadedness, more donor education by the staff at the collection site, more staff attention to donors with fear or higher risk for a vasovagal reaction (e.g. estimated blood volume near 3.5 l, first-time donor), and a more focused donation process to ensure a pleasant and safer procedure.
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Affiliation(s)
- Bruce H Newman
- American Red Cross Blood Services, Southeastern Michigan Region, Detroit, MI, USA
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49
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Diekamp U, Gneißl J, Rabe A, Kießig ST. Donor Hemovigilance during Preparatory Plasmapheresis. Transfus Med Hemother 2014; 41:123-33. [PMID: 24847188 PMCID: PMC4025159 DOI: 10.1159/000357991] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Reports on unexpected donor events (UEs) during preparatory plasmapheresis (PPP) are scarce, and rarely consider technical UEs. METHODS Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into the PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations and UEs from January 1, 2008 to June 30, 2011. RESULTS 66,822 UEs were observed during 1,107,846 PPPs for a corrected incidence of 6.55% (1.4% local, 0.55% systemic, 4.6% technical UEs). 3.36% of PPPs were accompanied by 1 UE and 1.18% by >1 UE (2-5). 13.7% of donors undergoing PPP for the first time, 9.7% of those having a second PPP and 4.0% of those having a third or more PPPs were associated with UEs. Most common UEs were repeated venipuncture, and broken-off collection due to venous access problems and small hematomas. Severe systemic UEs occurred at a rate of 36 per 100,000 PPPs. CONCLUSIONS Technical UEs were common with PPP. UEs accompanied first and second donations significantly more frequently than for subsequent donations.
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Risk factors for complications in donors at first and repeat whole blood donation: a cohort study with assessment of the impact on donor return. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s28-36. [PMID: 23867173 DOI: 10.2450/2013.0262-12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 02/28/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND First-time donation is among recognised risk factors for vasovagal reactions to blood donation and reactions are known to reduce donor return. We assessed associations between potential risk factors and vasovagal reactions and needle-related complications in first-time whole blood donation in comparison to repeat donation and analysed the impact of complications on donor return. MATERIALS AND METHODS We performed a cohort study on whole blood donations in The Netherlands from 1/1/2010 to 31/12/2010 using data extracted from the blood service information system. Donation data up to 31/12/2011 were used to ascertain donor return. RESULTS In 2010 28,786 donors made first whole blood donations and there were 522,958 repeat donations. Vasovagal reactions occurred in 3.9% of first donations by males and 3.5% of first donations by females compared to in 0.2% and 0.6%, respectively, of repeat donations. Associations of vasovagal reactions with other factors including age, body weight, systolic and diastolic blood pressure were similar in first-time and repeat donors. Needle-related complications occurred in 0.2% of male and 0.5% of female first-time donations and in 0.1% and 0.3%, respectively, of repeat donations. Among first-time donors, the return rate within 1 year was 82% following an uncomplicated first donation, but 55% and 61% following vasovagal reactions and needle-related complications, respectively; the corresponding percentages among repeat donors were 86%, 58% and 82%. DISCUSSION Among first-time donors, females suffered less than males from vasovagal reactions. Other risk factors had similar associations among first-time and repeat donors. Vasovagal reactions and needle-related complications in both first-time and repeat donors are followed by reduced donor return.
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