Morand Chrystelle, Coudurier Nicole, Rolland Carole, Thoret Sophie, Legrand Dominique, Tiberghien Pierre, Bosson Jean-Luc
Etablissement Français du Sang-Rhone-Alpes, Grenoble, France.
Etablissement Français du Sang, La Plaine Saint Denis, France.
Transfusion. 2016 Oct;56(10):2412-2421. doi: 10.1111/trf.13716. Epub 2016 Jul 24.
The prevention of presyncopal and syncopal reactions to whole blood donation is important for both the donor's safety and their retention as blood donors. The best strategy to achieve this remains debated.
A prospective cluster-randomized trial comparing three hydration modes (500 mL of an isotonic drink, 500 mL of water, just before phlebotomy, or advice to drink [control arm]) coupled or not with light muscle tensing exercises, was carried out in mobile and fixed units of two regional blood centers in southeast France between January and July 2014. The main outcome was the cumulative incidence of presyncope (feeling faint) and syncope (fainting) at the donation site or in the 48 hours after leaving the site. Secondary outcomes were the cumulative incidence of these adverse events during donation, immediately after blood donation, or within 48 hours.
Overall, presyncope or syncope occurred in 5.5% of the 4576 donors. Compared to controls, drinking 500 mL (isotonic solution or water) significantly reduced the rate of events (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.55-0.99; p = 0.041) independently of muscle tensing exercise. Muscle tensing exercises significantly reduced syncopal-type reactions during the donation (OR, 0.64; 95% CI, 0.42-0.98; p = 0.041), and an isotonic drink significantly reduced delayed off-site syncopal-type reactions (OR, 0.62; 95% CI, 0.40-0.98; p = 0.040) and tiredness after donation (OR, 0.75; 95% CI, 0.59-0.94; p = 0.014).
Drinking 500mL of water or isotonic drink close to phlebotomy is useful in preventing presyncopal or syncopal reactions in blood donors. Isotonic drinks have the advantage of preventing delayed reactions and tiredness after whole blood donation.
预防全血捐献时的前驱晕厥和晕厥反应对于献血者的安全及其继续献血都很重要。实现这一目标的最佳策略仍存在争议。
2014年1月至7月期间，在法国东南部两个地区血液中心的流动和固定采血点开展了一项前瞻性整群随机试验，比较三种补液方式（采血前饮用500毫升等渗饮料、500毫升水或仅给予饮水建议[对照组]），并搭配或不搭配轻度肌肉紧张运动。主要结局是在献血点或离开献血点后48小时内前驱晕厥（感到头晕）和晕厥（昏厥）的累积发生率。次要结局是这些不良事件在献血期间、献血后即刻或48小时内的累积发生率。
总体而言，4576名献血者中有5.5%发生了前驱晕厥或晕厥。与对照组相比，饮用500毫升（等渗溶液或水）可显著降低事件发生率（优势比[OR]，0.74；9 5%置信区间[CI]，0.55 - 0.99；p = 0.04 1），与肌肉紧张运动无关。肌肉紧张运动可显著降低献血期间的晕厥型反应（OR，0.64；95% CI，0.42 - 0.98；p = 0.04 1），等渗饮料可显著降低献血后延迟的现场外晕厥型反应（OR，0.62；95% CI，0.40 - 0.98；p = 0.04 0）以及献血后的疲劳感（OR，0.75；95% CI，0.59 - 0.94；p = 0.01 4）。
采血前饮用500毫升水或等渗饮料有助于预防献血者的前驱晕厥或晕厥反应。等渗饮料具有预防全血捐献后延迟反应和疲劳感的优势。
