Thijsen A, Masser B
Clinical Services and Research, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.
Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia.
Transfus Med. 2019 Apr;29 Suppl 1:13-22. doi: 10.1111/tme.12488. Epub 2017 Nov 16.
This narrative review examines current research on risk factors, prevention methods and management strategies for vasovagal reactions (VVRs) that occur during or as a result of blood donation. VVRs are important to blood collection agencies (BCAs) as they negatively impact the number of completed collections, perceptions of the safety of blood donation and rates of donor return. There has been significant progress in understanding and preventing VVRs in blood donation in recent years, with a multitude of risk factors identified. This has resulted in many BCAs implementing evidence-based strategies, such as donor age and weight restrictions. However, the profile of our most vulnerable donors and features of the donation setting that may protect these donors from experiencing a VVR have not been identified. Furthermore, an increased number of trials of physiological and psychological prevention interventions to reduce both immediate and delayed VVRs have been reported. However, a lack of methodological consistency in operationalising interventions to reduce or prevent VVRs means that the identification of effective VVR prevention strategies remains a challenge for practitioners. Furthermore, research is still required to determine how to successfully implement prevention and management strategies into standard operating procedures within collection centres. Finally, research in the management and mitigation of the effect of VVRs is currently only suggestive of what should be done to care for the donor who reacts and how to empower those donors to return. Collectively, research into these aspects of VVRs will provide support to donors and BCAs and improve the safety of blood donation.
本叙述性综述探讨了当前关于献血期间或献血后发生的血管迷走神经反应（VVRs）的危险因素、预防方法和管理策略的研究。VVRs对采血机构（BCAs）很重要，因为它们会对完成的采血数量、对献血安全性的认知以及献血者回访率产生负面影响。近年来，在理解和预防献血中的VVRs方面取得了重大进展，已确定了多种危险因素。这导致许多BCAs实施基于证据的策略，如对献血者年龄和体重的限制。然而，尚未确定最易发生VVRs的献血者特征以及可能保护这些献血者不发生VVRs的献血环境特征。此外，已有越来越多关于生理和心理预防干预措施以减少即时和延迟VVRs的试验报告。然而，在实施减少或预防VVRs的干预措施方面缺乏方法上的一致性，这意味着确定有效的VVRs预防策略对从业者来说仍然是一项挑战。此外，仍需要进行研究以确定如何在采血中心将预防和管理策略成功纳入标准操作程序。最后，目前关于VVRs影响的管理和缓解的研究仅表明了应对有反应的献血者采取何种措施以及如何促使这些献血者再次献血。总体而言，对VVRs这些方面的研究将为献血者和BCAs提供支持，并提高献血的安全性。
