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Schroyens N, D'aes T, De Buck E, Mikkelsen S, Tiberghien P, van den Hurk K, Erikstrup C, Compernolle V, Van Remoortel H. Safety and protection of plasma donors: A scoping review and evidence gap map. Vox Sang 2024; 119:110-120. [PMID: 37814964 DOI: 10.1111/vox.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND AND OBJECTIVES As part of a large-scale project to safely increase plasma collection in Europe, the current scoping review identifies the existing evidence (gaps) on adverse events (AEs) and other health effects in plasmapheresis donors, as well as factors that may be associated with such events/effects. MATERIALS AND METHODS We searched six databases and three registries. Study characteristics (publication type, language, study design, population, outcomes, associated factors, time of assessment, duration of follow-up, number and frequency of donations, convalescent plasma [y/n], setting and location) were synthesized narratively and in an interactive evidence gap map (EGM). RESULTS Ninety-four research articles and five registrations were identified. Around 90% were observational studies (57 controlled and 33 uncontrolled), and most of them were performed in Europe (55%) or the United States (20%). Factors studied in association with donor health included donor characteristics (e.g., sex, age) (n = 27), cumulative number of donations (n = 21), donation frequency (n = 11), plasma collection device or programme (n = 11), donor status (first time vs. repeat) (n = 10), donation volume per session (n = 8), time in donation programme (n = 3), preventive measures (n = 2) or other (n = 9). CONCLUSION The current scoping review provides an accessible tool for researchers and policymakers to identify the available evidence (gaps) concerning plasmapheresis donation safety. Controlled prospective studies with long-term donor follow-up are scarce. Furthermore, additional experimental studies comparing the health effects of different donation frequencies are required to inform a safe upper limit for donation frequency.
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Affiliation(s)
- Natalie Schroyens
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Tine D'aes
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Pierre Tiberghien
- Etablissement Français du Sang, Saint-Denis, France
- Université de Franche-Comté, EFS, INSERM, UMR Right, Besançon, France
| | - Katja van den Hurk
- Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Veerle Compernolle
- Belgian Red Cross, Blood Services, Mechelen, Belgium
- Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Meher R, Patidar GK, Chaurasia R, Pandey HC, Hazarika A. Prevention strategies for vasovagal reaction in whole blood donors: A quadri-armed randomised control trial. Transfus Med 2024; 34:20-29. [PMID: 38165089 DOI: 10.1111/tme.13026] [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: 09/04/2023] [Revised: 11/10/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Vasovagal reaction (VVR) is a frequently encountered generalised donor adverse reaction, associated with donor deterrence towards future donation. Several mitigation strategies for prevention of VVR were tried but still not standardised. This quadri-armed randomised study evaluated the utility of water ingestion, applied muscle tension (AMT) and combination of both in preventing the VVR among blood donors. METHODS A quadri-armed randomised controlled trial was performed on 4320 whole blood donors. Blood donors of 18-65 years of age were randomised into four groups based on the interventions performed i.e., control with no intervention (Group 1, n = 1081), water ingestion (Group 2, n = 1082), AMT (Group 3, n = 1070) and combined intervention (Group 4, n = 1087). VVR during and immediately after blood donation were observed along with assessment of risk factors in blood donors and the effectiveness of interventions were analysed. RESULTS The incidence of VVR observed 1.6% in our study, with the highest occurrence in the control group (2.5%) and the lowest in the combined intervention group (0.9%). Multivariable logistic regression revealed that the control group donors faced a 1.38-fold greater risk of VVR compared to those receiving interventions (OR: 1.38, 95% CI: 1.10-1.75). Other risk factors included younger age (OR: 1.5, 95% CI: 1.05-2.17), first-time donation (OR: 5.7, 95% CI: 1.66-5.74), prior history of VVR (OR: 2.5, 95% CI: 10.4-101.52). DISCUSSION/CONCLUSION The combined approach of water ingestion and AMT proved significantly more effective in VVR prevention compared to individual interventions.
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Affiliation(s)
- Radheshyam Meher
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Gopal Kumar Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Chaurasia
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Pandey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anjali Hazarika
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, 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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McMahon A, Kaptoge S, Walker M, Mehenny S, Gilchrist PT, Sambrook J, Akhtar N, Sweeting M, Wood AM, Stirrups K, Chung R, Fahle S, Johnson E, Cullen D, Godfrey R, Duthie S, Allen L, Harvey P, Berkson M, Allen E, Watkins NA, Bradley JR, Kingston N, Miflin G, Armitage J, Roberts DJ, Danesh J, Di Angelantonio E. Evaluation of interventions to prevent vasovagal reactions among whole blood donors: rationale and design of a large cluster randomised trial. Trials 2023; 24:512. [PMID: 37563721 PMCID: PMC10413586 DOI: 10.1186/s13063-023-07473-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 06/23/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Vasovagal reactions (VVRs) are the most common acute complications of blood donation. Responsible for substantial morbidity, they also reduce the likelihood of repeated donations and are disruptive and costly for blood services. Although blood establishments worldwide have adopted different strategies to prevent VVRs (including water loading and applied muscle tension [AMT]), robust evidence is limited. The Strategies to Improve Donor Experiences (STRIDES) trial aims to reliably assess the impact of four different interventions to prevent VVRs among blood donors. METHODS STRIDES is a cluster-randomised cross-over/stepped-wedge factorial trial of four interventions to reduce VVRs involving about 1.4 million whole blood donors enrolled from all 73 blood donation sites (mobile teams and donor centres) of National Health Service Blood and Transplant (NHSBT) in England. Each site ("cluster") has been randomly allocated to receive one or more interventions during a 36-month period, using principles of cross-over, stepped-wedge and factorial trial design to assign the sequence of interventions. Each of the four interventions is compared to NHSBT's current practices: (i) 500-ml isotonic drink before donation (vs current 500-ml plain water); (ii) 3-min rest on donation chair after donation (vs current 2 min); (iii) new modified AMT (vs current practice of AMT); and (iv) psychosocial intervention using preparatory materials (vs current practice of nothing). The primary outcome is the number of in-session VVRs with loss of consciousness (i.e. episodes involving loss of consciousness of any duration, with or without additional complications). Secondary outcomes include all in-session VVRs (i.e. with and without loss of consciousness), all delayed VVRs (i.e. those occurring after leaving the venue) and any in-session non-VVR adverse events or reactions. DISCUSSION The STRIDES trial should yield novel information about interventions, singly and in combination, for the prevention of VVRs, with the aim of generating policy-shaping evidence to help inform blood services to improve donor health, donor experience, and service efficiency. TRIAL REGISTRATION ISRCTN: 10412338. Registration date: October 24, 2019.
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Affiliation(s)
- Amy McMahon
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.
| | - Stephen Kaptoge
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Matthew Walker
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Susan Mehenny
- NHS Blood & Transplant, Blood Donation, Barnsley, UK
| | - Philippe T Gilchrist
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
- Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Jennifer Sambrook
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- National Institute for Health and Care Research BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Michael Sweeting
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- University of Leicester, Leicester, UK
| | - Angela M Wood
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Cambridge Centre of Artificial Intelligence in Medicine, University of Cambridge, Cambridge, UK
| | - Kathleen Stirrups
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- National Institute for Health and Care Research BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK
| | - Ryan Chung
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Sarah Fahle
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | - Elisha Johnson
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | - Donna Cullen
- NHS Blood & Transplant, John Radcliffe Hospital, Oxford, UK
| | | | - Shannon Duthie
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | | | - Paul Harvey
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | - Michael Berkson
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | - Elizabeth Allen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | - Nicholas A Watkins
- Data, Analytics and Surveillance, UK Health Security Agency, Nobel House, London, UK
| | - John R Bradley
- National Institute for Health and Care Research BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK
| | - Nathalie Kingston
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- National Institute for Health and Care Research BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Jane Armitage
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David J Roberts
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- NHS Blood & Transplant, John Radcliffe Hospital, Oxford, UK
- Radcliffe Dept of Medicine and BRC Haematology Theme, University of Oxford, Oxford, UK
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Emanuele Di Angelantonio
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Health Data Science Centre, Human Technopole, Milan, 20157, Italy
- NHS Blood and Transplant, Cambridge, UK
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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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Ibrahim NN, Mohd Noor NH, Zulkafli Z. Prevalence and factors associated with vasovagal reaction among whole blood donors in hospital Universiti Sains Malaysia. Transfus Clin Biol 2023; 30:238-243. [PMID: 36702200 DOI: 10.1016/j.tracli.2023.01.004] [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: 11/09/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023]
Abstract
Adverse donor reactions (ADR) are common to occur during the blood donation process. The most common is vasovagal reactions (VVR) and it cause negative impact in the donor return rate. The aim of this study is to determine the prevalence of VVR among blood donors and to study its associated factors, at Hospital University Sains Malaysia (USM). This retrospective case-control study was conducted from June 2018, until June 2021. Data was extracted from the blood bank database system and from donor adverse reaction form. Donors who developed adverse donor reactions were chosen and without VVR were chosen at random as controls. A total of 159 donors, out of 35 134 donors were reported to have VVR which resulted in an overall prevalence of 0.45 %. Dizziness or mild VVR were the most frequently observed adverse reactions, accounting for approximately 87/159 (54.7 %) of all adverse reactions. Multiple logistic regression (MLR) analysis showed VVR were significantly associated with age, female gender, first-time donor, and 450 ml volume of blood collected. The prevalence of vasovagal reactions among blood donors in this study was low which was similar to a few previous studies. Although it was low, still it is very important to reduce risks to a minimum so that the donor return rate could be maintained. The information regarding its associated factors can be used to identify high-risk donors to prevent the incidence in the future.
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Affiliation(s)
- Nur Nasuha Ibrahim
- Department of Hematology and Transfusion Medicine Unit, School of Medical Science, Health Campus, University Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Noor Haslina Mohd Noor
- Department of Hematology and Transfusion Medicine Unit, School of Medical Science, Health Campus, University Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Zefarina Zulkafli
- Department of Hematology and Transfusion Medicine Unit, School of Medical Science, Health Campus, University Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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7
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Lewin A, Deschênes J, Rabusseau I, Thibeault C, Renaud C, Germain M. Pre-donation water and salty snacks to prevent vasovagal reactions among blood donors. Transfusion 2023; 63:156-162. [PMID: 36345887 DOI: 10.1111/trf.17173] [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: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Minimizing the risk of vasovagal reactions (VVRs) can prevent donor harms and improve donor return. We report the results of a program to reduce VVR rates. STUDY DESIGN AND METHODS The program was implemented on June 11, 2017 and consisted in drinking water and eating a salty snack before donating blood, plasma, or platelets. All donations made during the "pre-program period" (October 11, 2015-June 10, 2017) and "post-program period" (June 11, 2017-May 11, 2019) were included. Study outcomes comprised VVRs (any severity) and syncopal VVRs, whether employee- or donor-reported. An interrupted time series (ITS) analysis proxied causality based on the "pre-program trend," the "immediate trend" (i.e., immediately before versus after the program), and the "post-program trend". The relative risk (RR) of VVR (along with confidence intervals [CIs]) was reported, overall and stratified by subgroups based on age, sex, donor type (i.e., first-time versus repeat), and donation type (i.e., whole blood versus apheresis). RESULTS The monthly VVR rate (any severity) dropped from 4.6% in the pre-program period to 4.3% in the post-program period, and never reached its pre-program level. The ITS analysis revealed a statistically significant and increasing pre-program trend (RR [95% CI] = 1.011 [1.002-1.020]), a statistically significant and decreasing immediate trend (RR [95% CI] = 0.848 [0.743-0.969]), and a non-statistically-significant and stable post-program trend (RR [95% CI] = 0.999 [0.993-1.006]). Similar trends were observed for nearly all high- and low-risk subgroups. No statistically significant trend was observed for syncopal VVRs. DISCUSSION These results suggest that the herein-described program durably reduced the incidence of VVRs (any severity) by ~15%.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada.,Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jessyka Deschênes
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Isabelle Rabusseau
- Medical Affairs and Innovation, Héma-Québec, Québec City, Quebec, Canada
| | | | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Québec City, Quebec, Canada
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8
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Wang C, Chen L, Sun C, Zhang Y, Cao C, Ma Y, Shi W. Prevention of Blood Donation-related Vasovagal Response by Applied Muscle Tension: a Meta-analysis. J Int Med Res 2022; 50:3000605221121958. [PMID: 36127814 PMCID: PMC9500294 DOI: 10.1177/03000605221121958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Vasovagal reaction (VVR) is an adverse reaction to blood donation. Applied
muscle tension (AMT) has been reported to reduce the probability of VVR
during blood donation; however, the results have been controversial. We
therefore conducted a meta-analysis to systematically evaluate the effect of
AMT in reducing VVR. Methods We searched six major databases using “applied muscle tension” and “blood
donation-related vasovagal response” as keywords. Relevant articles
published in English or Chinese between 1 January 2000 and 30 June 2021 were
included in the analysis. The quality of the included articles was evaluated
and publication bias was assessed by forest and funnel plots and by Egger's
test. Results Fifty-one articles were identified, of which six were included according to
the pre-defined inclusion and exclusion criteria. A fixed-effects model was
adopted for effect size combination and revealed a relative risk of 0.52
(95% confidence interval 0.40 to 0.67). The AMT group was superior to the
control in terms of VVR prevention. A funnel plot and Egger's test suggested
that the findings were accurate and reliable with low publication bias. Conclusion AMT could effectively reduce VVR during blood donation. Further multicenter
studies with large sample sizes are needed to confirm these results.
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Affiliation(s)
- Cong Wang
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Li Chen
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago 60657, IL, USA
| | - Yan Zhang
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Can Cao
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Yuanyuan Ma
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Wenwen Shi
- Hebei Province Blood Center, Shijiazhuang 050011, China
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9
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de Farias CLG, de Oliveira Alves LB, Mendrone-Junior A, de Araújo Arrais C, Duran A, Rocha V, de Almeida-Neto C. The impact of immediate adverse donation reactions on the return of volunteers undergoing platelet apheresis. Transfus Apher Sci 2022; 61:103424. [DOI: 10.1016/j.transci.2022.103424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/22/2022] [Accepted: 03/13/2022] [Indexed: 11/25/2022]
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10
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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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11
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Thijsen A, Thorpe R, Davison TE, Nguyen L, Masser B. The vasovagal reaction experience among blood donors: A qualitative study of factors that affect donor return. Soc Sci Med 2021; 282:114142. [PMID: 34153820 DOI: 10.1016/j.socscimed.2021.114142] [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: 07/20/2020] [Revised: 05/05/2021] [Accepted: 06/11/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE Blood collection agencies face ongoing challenges in retaining voluntary donors to meet the demand for blood and blood-related products by healthcare services. A known deterrent to continued blood donation is the experience of a vasovagal reaction (VVR). However, there has been little research into donors' experiences of these reactions and the factors that influence their decision to return, which is essential information to inform strategies to improve donor return. OBJECTIVE The aim of this paper was to explore blood donor views and experiences of a VVR, with a particular interest in how the reaction influenced their return behaviour, using the Transactional Model of Stress and Coping. METHODS We conducted 34 semi-structured in-depth interviews between February and April 2018 with a sample of Australian donors who had experienced a VVR in the last seven days. Transcripts were analysed using the Framework Method. RESULTS The VVR elicited various emotional responses, which appeared to be influenced by social support, being aware of the possibility of experiencing a VVR, or the donation outcome. In turn, the VVR experience affected intentions to return, with those who reported more positive experiences expressing stronger intentions. Further, donors felt more likely to return if they perceived their risk of a recurrent event as low and if they were able to identify appropriate problem and emotion-focused coping strategies. CONCLUSION This article provides novel insights into possible ways to encourage blood donor return following a VVR.
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Affiliation(s)
- Amanda Thijsen
- Australian Red Cross Lifeblood, 17 O'Riordan Street, Alexandria, New South Wales, 2015, Australia.
| | - Rachel Thorpe
- Australian Red Cross Lifeblood, 417 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Tanya E Davison
- Australian Red Cross Lifeblood, 417 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Lilly Nguyen
- Australian Red Cross Lifeblood, 417 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Barbara Masser
- The University of Queensland, School of Psychology, Sir Fred Schonell Dr, St Lucia, Queensland, 4072, Australia; Australian Red Cross Lifeblood, 44 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia
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12
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Wasiluk T, Rybinska K, Rogowska A, Boczkowska-Radziwon B, Radziwon P. Comment on "Donor tolerability of convalescent plasma donation". J Clin Apher 2021; 36:673-674. [PMID: 34021634 DOI: 10.1002/jca.21912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Tomasz Wasiluk
- Regional Centre for Transfusion Medicine, Bialystok, Poland
| | | | - Anna Rogowska
- Regional Centre for Transfusion Medicine, Bialystok, Poland
| | | | - Piotr Radziwon
- Regional Centre for Transfusion Medicine, Bialystok, Poland.,Department of Hematology, Medical University of Bialystok, Bialystok, Poland
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13
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Goldman M, Uzicanin S, Marquis-Boyle L, O'Brien SF. Implementation of measures to reduce vasovagal reactions: Donor participation and results. Transfusion 2021; 61:1764-1771. [PMID: 33880796 DOI: 10.1111/trf.16375] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are several strategies to reduce donor reactions. We report donor participation and reaction rates before and after implementing multiple measures at Canadian Blood Services. STUDY DESIGN AND METHODS We introduced a structured program of 500 mL of water and a salty snack pre-donation and applied muscle tension (AMT) during donation. Donors were not deferred for out of range blood pressure (BP); however, BP was measured in first time donors. Time on the donation chair post-donation was decreased from 5 to 2 min for repeat donors. We assessed participation rates using our quarterly survey of 10,000 recent donors. We extracted vasovagal reactions with loss of consciousness (LOC) from our operational database and compared pre-implementation (Oct 12,018-March 31,2019) and post-implementation (Oct 12,019-March 31,2020) periods. RESULTS Survey response rates varied from 11% to 16%. The percentage of donors who drank the water and ate the salty snack increased from 58% to 82% and 44% to 70% over 4 quarters; those performing AMT increased from 24% to 41%. Reactions decreased from 19.07 per 10,000 (744 reactions in 390,123 donations) to 14.04 per 10,000 (537 in 382,382 donations) (p < .0001). No first-time donors with high BP (n = 684) but 5 with low BP (n = 718) had reactions, CI were very large. CONCLUSIONS Achieving optimal participation was challenging. After implementation of a donor wellness initiative based on best practice, rates of vasovagal reactions with LOC decreased by 25%. A larger dataset is necessary to assess the safety contribution of BP deferrals when other mitigation measures are in place.
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Affiliation(s)
- Mindy Goldman
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Samra Uzicanin
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Lynne Marquis-Boyle
- Supply Chain Process Management, Canadian Blood Services, Saint John, New Brunswick, Canada
| | - Sheila F O'Brien
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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14
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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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15
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Thijsen A, Masser B, Davison TE, Kruse SP, Williamson A. Examining knowledge translation in blood donor research: A review of vasovagal reaction literature. Transfusion 2021; 61:1772-1779. [PMID: 33797069 DOI: 10.1111/trf.16391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Knowledge translation focuses on the transfer of research findings into policy and practice. To provide insight into the state of knowledge translation in blood donor research, we undertook a rapid review of a key research area in the field with high potential for translation, vasovagal reactions (VVRs). We examined the number and nature of VVR-related studies to determine the availability of research evidence, and mapped the included articles along the research-to-practice trajectory using the Knowledge to Action framework. STUDY DESIGN AND METHODS PubMed, PsycINFO, CINAHL, and EMBASE were searched for peer-reviewed journal articles from inception to October 2019 using the terms blood don* AND vasovagal OR faint* OR syncope. RESULTS A total of 176 articles met our inclusion criteria. Studies relating to VVRs increased substantially from 1942 to 2019, with 84% published in the last 20 years. Articles were predominately observation (non-intervention) studies (117; 66%), followed by intervention (knowledge inquiry) studies (31; 18%) and review (knowledge synthesis) studies (20; 11%). The evidence from intervention research was limited, with 14 strategies tested in 31 studies and often by the same research groups. Only 5 (3%) implementation and evaluation studies were found; all focused on evaluating the effects of a newly introduced intervention on VVR rates through uncontrolled or cross-sectional study designs. DISCUSSION VVR research is in the early stages of knowledge translation. More intervention research is needed to provide a robust evidence base as well as more published implementation research to share knowledge of translating research into policy and practice.
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Affiliation(s)
- Amanda Thijsen
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Sarah P Kruse
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Anna Williamson
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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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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OʼBrien SF. Donor education – times change and we with time. Transfusion 2020; 60:1649-1652. [DOI: 10.1111/trf.15977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Sheila F. OʼBrien
- Epidemiology and SurveillanceCanadian Blood Services Ottawa ON Canada
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18
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Thijsen A, Masser B, Davison TE. Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading. Transfusion 2020; 60:918-921. [DOI: 10.1111/trf.15701] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/18/2019] [Accepted: 12/28/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Amanda Thijsen
- Clinical Services and ResearchAustralian Red Cross Lifeblood Sydney New South Wales Australia
| | - Barbara Masser
- Clinical Services and ResearchAustralian Red Cross Lifeblood Brisbane Queensland Australia
- School of PsychologyThe University of Queensland Brisbane Queensland Australia
| | - Tanya E. Davison
- Clinical Services and ResearchAustralian Red Cross Lifeblood Melbourne Victoria Australia
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19
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Ferguson E, Murray C, O’Carroll RE. Blood and organ donation: health impact, prevalence, correlates, and interventions. Psychol Health 2019; 34:1073-1104. [DOI: 10.1080/08870446.2019.1603385] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Catherine Murray
- Division of Psychology, University of Stirling, Stirling, Scotland
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20
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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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21
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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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22
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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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23
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Edgren G, Hjalgrim H. Epidemiology of donors and recipients: lessons from the SCANDAT database. Transfus Med 2017; 29 Suppl 1:6-12. [PMID: 29148106 DOI: 10.1111/tme.12487] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/04/2017] [Accepted: 10/16/2017] [Indexed: 02/03/2023]
Abstract
With the development of several 'vein-to-vein' databases, which capture data on the entire donor-recipient continuum and link this data to health outcomes, there has been an increasing number of studies investigating the health effects of all aspects of the practice of transfusion medicine. The Scandinavian Donations and Transfusions (SCANDAT) database is one of several such databases, which includes all electronically available data on blood donors, donations and transfusions since the late 1960s in Sweden and the early 1980s in Denmark. The SCANDAT database has been used to characterise disease occurrence among blood donors and transfused patients, as well as to investigate possible health effects of blood donations, aspects of transfusion care and possible transfusion transmission of disease. Recent publications include studies on recipient mortality associated with the storage lesion, studies on the effects of donor demographics on patient mortality and health effects of frequent blood donation. Although this research approach is clearly very powerful, the appropriate analysis of such real-world data is complex and requires close methodological attention. The purpose of this review is to present some of the research conducted within the SCANDAT collaboration. We hope more international collaboration may help improve our understanding of the important remaining questions about donor and recipient health.
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Affiliation(s)
- G Edgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - H Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
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24
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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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25
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Ramond A, Roberts DJ. 2016 European Conference on Donor Health and Management. Transfus Med 2017; 27:235-237. [PMID: 28805334 DOI: 10.1111/tme.12454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Ramond
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - D J Roberts
- National Health Service Blood and Transplant, Oxford, UK.,BRC Haematology Theme and Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
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26
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Daniel Y, Sailliol A, Pouget T, Peyrefitte S, Ausset S, Martinaud C. Whole blood transfusion closest to the point-of-injury during French remote military operations. J Trauma Acute Care Surg 2017; 82:1138-1146. [PMID: 28328685 DOI: 10.1097/ta.0000000000001456] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
To improve the survival of combat casualties, interest in the earliest resort to whole blood (WB) transfusion on the battlefield has been emphasized. Providing volume, coagulation factors, plasma, and oxygenation capacity, WB appears actually as an ideal product severe trauma management. Whole blood can be collected in advance and stored for subsequent use, or can be drawn directly on the battlefield, once a soldier is wounded, from an uninjured companion and immediately transfused.Such concepts require a great control of risks at each step, especially regarding ABO mismatches, and transfusion-transmitted diseases. We present here the "warm and fresh" WB field transfusion program implemented among the French armed forces. We focus on the followed strategies to make it applicable on the battlefield, even during special operations and remote settings, and safe for recipients as well as for donors.
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Affiliation(s)
- Yann Daniel
- French Medical Unit, Naval Special Operations Commandos Command, Lanester, France (Y.D., S.P.); French Military Blood Institute, Clamart, France (A.S., T. P., C.M.); Anaesthesia and Intensive Care Unit, Percy Military Teaching Hospital, Clamart, France (S. A.); and Department of Biology, Laveran Military Teaching Hospital, Marseille, France (C.M.)
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27
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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: 4] [Impact Index Per Article: 0.5] [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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