Is donating blood for the faint of heart? a systematic review of predictors of syncope in whole blood donors

Donald, Scott; McIntyre, William F.; Dingwall, Orvie; Hiebert, Brett; Ponnampalam, Arjuna; Seifer, Colette

doi:10.1111/trf.15442

Cited by 14 publications

(17 citation statements)

References 15 publications

(41 reference statements)

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“…While first‐time donors are at a greater risk of experiencing a VVR, the implementation of the donor safety strategies was also found to be beneficial for repeat donors. The odds of experiencing a VVR was reduced by 10% in first‐time donors compared to 13% among repeat donors.…”

Section: Discussionmentioning

confidence: 99%

Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading

2020

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BACKGROUND: A new national donor safety initiative was introduced in Australia in 2018, which aimed to encourage all whole blood donors to water load and to use applied muscle tension. This study evaluated the effect of this initiative on the rate of vasovagal reactions (VVR). STUDY DESIGN AND METHODS: Routinely collecteddata were used to identify whole blood donations and any associated VVRs before (n = 167,056 donations) and after implementation (n = 215,572 donations). Multivariate logistic regression analyses were performed to evaluate the differences in VVR rates.

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Section: Discussionmentioning

confidence: 99%

Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading

2020

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“…The mechanisms of faint and pre‐faint reactions (anxiety, nervousness, dizziness, sweating, pallor) sometimes called vasovagal reactions, are incompletely understood, with both physiologic factors, such as hypovolemia, and psychologic factors, such as neural mediated reflexes, contributing 4–6 …”

Section: Introductionmentioning

confidence: 99%

“…Many mitigation strategies have been implemented by different blood centers to decrease the risk of vasovagal reactions 5 …”

Section: Introductionmentioning

confidence: 99%

Implementation of measures to reduce vasovagal reactions: Donor participation and results

et al. 2021

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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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“…A recent systematic review showed that young age was a risk factor for syncope during and after blood donation in all seven studies reviewed [10]. Previously from our institution, one of the reported risk factors of IR was younger age [11].…”

Section: Discussionmentioning

confidence: 99%

Syncopal‐type reactions tend to be delayed and result in falls among elderly blood donors

et al. 2020

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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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Is donating blood for the faint of heart? a systematic review of predictors of syncope in whole blood donors

Cited by 14 publications

References 15 publications

Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading

Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading

Implementation of measures to reduce vasovagal reactions: Donor participation and results

Syncopal‐type reactions tend to be delayed and result in falls among elderly blood donors

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