Predictors of vasovagal reactions during preoperative autologous blood donation: a single-institution analysis

Abstract

Studies examining risk factors associated with vasovagal reactions (VVRs) during autologous blood donations, especially in younger subjects, have been limited. The aim of the present study was to define risk factors for VVRs during preoperative autologous blood donation in patients, including those younger than 18 years old. We retrospectively analyzed 4,192 autologous, preoperative blood donations between 2007 and 2015 at Okayama University Hospital. Eighty-seven (2.08%) of the patients experienced VVRs. VVRs occurred approximately three times as often in patients 0-17 years old (16/320, 5.0%) than in patients 18 years and older (71/3,872, 1.8%). In particular, VVRs occurred more frequently in those 10-13 years old, and decreased with older age (P = 0.006). In a univariate analysis, younger age, lower body mass index, lower systolic blood pressure, lower body weight, lower total blood volume, female gender, first-time collection, and higher heart rate were associated with a higher incidence of VVRs. In a multivariate analysis, lower systolic blood pressure (P < 0.001), higher heart rate (P = 0.007), and first-time collection (P = 0.015), remained independent predictors of VVRs. These results emphasize the need for careful attention during blood collection. Keywords: Autologous blood donation, vasovagal reactions 3 IntroducitonAutologous blood donation is widely used for preoperative blood preparation to reduce exposure to allogeneic blood [1]. Autologous and allogeneic blood donors occasionally experience adverse reactions during or after blood withdrawal, such as weakness, pallor, nausea, sweating, and fainting [2,3]. These symptoms are generally called "vasovagal reactions" (VVRs) [2,4]. However, the pathophysiology of VVRs is not yet completely understood [5]. Although risk factors for VVRs have been analyzed mainly in healthy allogeneic donors or peripheral blood stem cell donors [2,4,[6][7][8], reports describing patients undergoing autologous collection have been limited. In particular, there are few data concerning patients younger than 16-18 years old. In the present study, we analyzed the risk factors for VVRs during autologous donation in patients, including those younger than 18 years old, at a single institution. Materials and methodsWe retrospectively collected medical information from 4,192 patients (groups I + II) who underwent autologous Patients were screened for vital signs, height, body weight, and complete blood count. Enrolled patients underwent whole blood phlebotomy in a designated room: blood volumes did not exceed 400 mL, or [body weight]/50 × 400 mL if the patient's body weight was less than 50 kg. All collections were conducted by a physician and nurse from the Department of Transfusion Medicine at Okayama University Hospital. An 18-gauge needle was inserted into an antecubital vein or a large forearm vein of each patient, and autologous blood was collected using a negative pressure blood drawing device (Hemoquick; Terumo, Tokyo, Japan). After phlebotomy, the patients were adm...

Prospective analysis of syncope/pre‐syncope in a tertiary paediatric orthopaedic fracture outpatient clinic

“…The incidence of VVS associated with blood donation has been reported in the general literature as between 0.13% and 4.17% 3–5,9 . The majority of estimates come from national blood donation registry data.…”

“…Nishimori et al . retrospectively analysed blood donation centre data and found a three‐fold increased risk of VVS in donors younger than 18 years, with donors aged between 10 and 13 years most likely affected 9 …”

Development and Validation of a Nomogram to Predict the Risk of Blood Transfusion in Orthognathic Patients

“…[13][14][15][16][17][18] Therefore, PABD has been widely used in elective surgery with potential serious blood loss because it is safer, more convenient and economical than allogeneic blood transfusion. [19][20][21] However, routine PABD has not been recommended for orthognathic patients because the probability of blood transfusion significantly varies owing to the different preoperative conditions, surgical procedures, operation duration, and blood loss in individual patient. [22][23][24][25][26][27] Therefore, it is necessary to establish a prediction model to predict the probability of blood transfusion and the need for PABD in patients with orthognathic surgery.…”

Vasovagal syncope related to pain procedures in a pain clinic at a tertiary Lebanese hospital between 2016 and 2019

“…Many studies were done regarding VVS related to invasive procedures like for example blood donation [3][4][5] but very few approached fainting in the setting of pain procedures. A previous study done regarding the effects of lumbar spinal nerve analgesia on the cardiovascular system [6] showed a minor rise in systolic and diastolic blood pressure, heart rate as well as a normalization of these parameters after the nerve root infiltration.…”