Can prehydration with different fluids or applied muscle tension prevent or attenuate adverse effects in blood donors?

Mrigendra Amatya

doi:10.3126/nmcj.v22i1-2.30034

Abstract

Adverse effects (AE) like vasovagal reactions (presyncope and syncope) have negative impact on old as well as new blood donors. Various methods have been suggested to prevent or attenuate AE in blood donors. This study assessed the effectiveness of prehydration with different fluids or applied muscle tension (AMT) during blood donation in preventing or attenuating AE. Consenting and eligible voluntary blood donors (n=448) were randomly allocated to Control (n=115), prehydration with 500 mL plain water (PW, n=97), prehydration with oral rehydration solution (ORS, n=71), prehydration with 400 mL fruit juice (FJ, n=74), or leg muscle tensing during blood removal (AMT, n=91) groups. Donors’ hemodynamic responses to blood donation were assessed by comparing blood pressures (systolic–SBP and diastolic–DBP) and heart rate (HR) recorded before blood removal to values midway during, and at 0 min, 5 min, 10 min and 15 min after blood removal. Presyncope and syncope were defined by BP and HR changes. Subjective AE were also recorded. Overall, 35 donors (7.8%) suffered AE with highest rates in PW (13.4%) and ORS (11.3%) groups and lowest in Control (3.5%) although group differences were not significant (p>0.05, Chi square). Blood removal was associated with significant falls in SBP and DBP (mean falls by 6.63 and 3.35 mmHg, respectively; p<0.001) but an insignificant rise in HR (mean increase by 0.67 bpm, p>0.05). Hemodynamic responses showed significant differences between groups (p<0.001, repeated measures ANOVA). Therefore, role of the interventions in relation to AE in blood donors could not be established.

Highlights

Blood donation is a generally safe procedure
The FJ and applied muscle tension (AMT) groups had higher heart rate (HR) compared to rest of the groups
There was a decline in blood pressure with blood removal which steadied towards later parts of the observation time whereas HR mostly remained at a level comparable to intial values (Fig. 2)

Summary

Introduction

Blood donation is a generally safe procedure. A small pecentage of donors may experience adverse effects (AE).[1,2] Various factors are found to be associated with increased risk for such events, mostly non-modifiable, such as age, sex, weight and number of past donations.[2] Incidences of adverse reactions have significant effects on the return behavior of the donors. The common methods are ingestion of plenty of fluid before blood donation (prehydration) and muscle tensing exercises during blood donation.[5,6,7,8] Prehydration technique is commonly used in other hypotensive situations such as postural orthostatic hypotension and exercise conditions, and with various types of fluid.[9,10,11] Different methods including different types of fluid have not been reported to be tested in a single study and in field settings of blood donation

Methods

Results

Discussion

Conclusion