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Physiologic strategies to prevent fainting responses during or after whole blood donation.
MedLine Citation:
PMID:  21645008     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Vasovagal syncope (VVS) is a consistent, but infrequent (0.1%-0.3%) complication of volunteer, whole blood donation. Given the large number of blood donations, a significant number of donors is involved. Syncope occasionally leads to injury. Recent rigorous data collection and analysis have led to the association of a small number of donor and donation factors with the risk of syncope. An analysis of the time course of syncope reactions among approximately 500,000 whole blood donors suggests that there are three distinct periods of risk for vasovagal reactions before, during, and after phlebotomy. This review examines the physiologic mechanisms that contribute to these periods of increased risk including the direct effects of removal of approximately 500 mL of whole blood, the psychological stress of instrumentation and giving blood (i.e., fear of needles, pain, and the sight of blood), and the orthostatic effects superimposed on a hypovolemic state after the donation. Specifically, we describe interventions that have been useful in controlling VVS in patients with fainting syndromes and we examine the potential of these interventions in the blood donation context, based on the physiologic principles involved. Finally, we propose an intervention (dietary replacement of salt lost with blood donation) that has not been applied in transfusion medicine previously but which has the potential to reduce risk.
Authors:
Wouter Wieling; Christopher R France; Nynke van Dijk; Hany Kamel; Roland D Thijs; Peter Tomasulo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-3
Journal Detail:
Title:  Transfusion     Volume:  -     ISSN:  1537-2995     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 American Association of Blood Banks.
Affiliation:
From the Department of Medicine and the Department of General Practice/Family Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands; the Department of Psychology, Ohio University, Athens, Ohio; Blood Systems, Inc., Scottsdale, Arizona; the Dutch Epilepsy Clinics Foundation (SEIN), Heemstede, The Netherlands; and the Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
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