The acute effects of whole blood donation on cardiorespiratory and haematological factors in exercise: A systematic review

Abstract

Background This systematic review aimed to collect the relevant historical and current literature to produce an informed analysis of the acute effects on cardiorespiratory and haematological factors following whole blood donation (~ 470 ml) during exercise. Testing the hypothesises that blood donation produces either no changes (Null) or produces significant changes (alternate) in haematology, , heart rate, exercising power and time. Methods Four databases of medical and science orientations were searched with terms sensitive to connections regarding exercise, blood donation (400–500 ml)/haematology, , heart rate, exercising power and time. The study retrieval process utilised the PRISMA approach and selection was via an adapted scoring method according to the Consensus based Standards for the selection of health Measurements Instruments (COSMIN). Systematic review focused on 24–48 hrs post donation. Details of the PRSIMA checklist can be found in the accompanying online document. Results Following scrutiny of 48 research papers by two independent assessors 8 experimental studies were included. Four studies showed a mean reduction for difference in (- 2.4 ± 1.4 ml∙kg -1 ∙min -1 ) and a medium effect size (-0.26). No statistical significance was present at the mean meta-analysis level, also the case for heart rate, time to exhaustion and power. A mean reduction was seen in haemoglobin (- 1.05 g . dL -1 ), haematocrit (- 3.71%) and red blood cells (- 0.44 Mio μL -1 ), very large effect size was observed (Cohen’s d , -0.75, -1.16 and -4.23 respectively) and statistical significance (95% CI, -2.04, -0.54; -4.59, 2.28 and -4.37, -4.10 respectively). Conclusion Although individual studies show that Is reduced from blood donation pooled results show that is indeed not significantly reduced from blood donation 24–48 hrs post donation. Additionally sub-maximally there isn’t enough data to produce substantial comparatives. Furthermore, this systematic review demonstrates that there are not enough high-quality studies regarding cardiorespiratory outcomes following blood donation.

Hemoglobin modulation affects physiology and patient reported outcomes in anemic and non-anemic subjects: An umbrella review

“…( Van Remoortel et al (2017 ) evaluated several studies that compared healthy adults that underwent blood donation before and after donation, and one study that used sham bleeding as comparator. Johnson et al (2019 ) performed a similar SR with comparable eligibility criteria. The results and conclusions presented by Johnson et al (2019 ) were not completely understood, and Johnson et al (2019 ) could unfortunately not be reached for comments.…”

“… Johnson et al (2019 ) performed a similar SR with comparable eligibility criteria. The results and conclusions presented by Johnson et al (2019 ) were not completely understood, and Johnson et al (2019 ) could unfortunately not be reached for comments. Intriguingly, Johnson and Van Remoortel reached contrasting conclusions.…”

Factors confounding the athlete biological passport: a systematic narrative review

“…the withdrawal of large amounts of blood), [Hb] was decreased immediately after withdrawal [111] while a measurable increase in reticulocytes was sometimes delayed for a few days [30]. However, most haematological disorders observed in athletes were not associated with exceeding the limits of the model used to detect rhEPO [90].…”

“…Some haematological disorders were reported to alter [Hb], with these athletes exhibiting lower values than those of healthy athletes [90]. With some athletes suffering from haemochromatosis (a pathological condition requiring the withdrawal of large amounts of blood), [Hb] was decreased immediately after withdrawal [111] while a measurable increase in reticulocytes was sometimes delayed for a few days [30]. However, most haematological disorders observed in athletes were not associated with exceeding the limits of the model used to detect rhEPO [90].…”

Impairment in maximal lactate steady state after carbon monoxide inhalation is related to training status

“…Numerous studies have attempted to identify the extent to which ‘central’ and ‘peripheral’ factors limit maximal oxygen uptake ($${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{max}}}$$) or its surrogate, $${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$$ (Bassett & Howley, 2000; Johnson et al., 2019; Lundby et al., 2017), but the contribution of these factors to prolonged exercise is underexamined. $${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{max}}}$$ is primarily limited by convective O 2 delivery in most, and particularly in well‐trained, individuals, as demonstrated by blood withdrawal studies (Kanstrup & Ekblom, 1982; Panebianco et al., 1995; Van Remoortel et al., 2017), but peripheral factors seem to limit $${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{max}}}$$ in untrained individuals to some extent (Bassett & Howley, 2000; Cardús et al., 1998; Gifford et al., 2016).…”