Ohio University, Athens, Ohio 45701, USA.
Transfusion. 2010 Jun;50(6):1257-64. doi: 10.1111/j.1537-2995.2009.02574.x. Epub 2010 Jan 22.
A randomized controlled trial was conducted to test the effects of hydration and applied muscle tensing on presyncopal reactions to blood donation. Both interventions are designed to prevent the decreases in blood pressure that can contribute to such reactions, but due to the distinct physiologic mechanisms underlying their pressor responses it was hypothesized that a combined intervention would yield the greatest benefit.
Before blood donation, first- and second-time blood donors (mean age, 20.2 years; SD, 4.9) were randomly assigned to 1) standard donation, 2) placebo (leg exercise before venipuncture), 3) predonation water, or 4) predonation water and leg exercise during donation.
Main effects of group were observed for phlebotomist classification of vasovagal reactions (chi(2)(3) = 8.38, p < 0.05) and donor reports of presyncopal reactions (chi(2)(3) = 13.16, p < 0.01). Follow-up analyses of phlebotomist classifications revealed fewer reactions in the predonation water and predonation water and leg exercise groups relative to placebo but not standard donation. Follow-up analyses of self-reported reactions revealed that women, but not men, had lower scores in both the predonation water and the predonation water and leg exercise groups relative to both placebo and standard donation.
Predonation hydration and a combination of hydration and leg exercise may help attenuate presyncopal reactions in relatively novice donors, although future studies with larger samples are required to confirm this effect.
一项随机对照试验旨在测试水合作用和应用肌肉紧张对献血前晕厥反应的影响。这两种干预措施旨在防止血压下降,而血压下降可能导致这种反应,但由于其升压反应的基础生理机制不同,因此假设联合干预将产生最大的益处。
在献血前,首次和第二次献血者(平均年龄 20.2 岁,标准差 4.9)随机分为 1)标准献血,2)安慰剂(静脉穿刺前腿部运动),3)献血前水合,或 4)献血前水合和献血时腿部运动。
主要组效应观察到静脉切开术者分类的血管迷走神经反应(卡方(3)= 8.38,p < 0.05)和献血者报告的晕厥前反应(卡方(3)= 13.16,p < 0.01)。对静脉切开术者分类的后续分析显示,与安慰剂相比,预水合和预水合加腿部运动组的反应较少,但与标准献血组无差异。对自我报告反应的后续分析显示,女性而非男性在预水合和预水合加腿部运动组的反应评分均低于安慰剂和标准献血组。
预献血水合和水合加腿部运动的组合可能有助于减轻相对新手献血者的晕厥前反应,但需要更大样本的未来研究来证实这种效果。