Wiersum-Osselton Johanna, Romeijn Bas, van den Brekel Elise, van Dongen Anne, Hermans Frank, Bokhorst Arlinke, Marijt-van der Kreek Tanneke
Sanquin, Unit Donor Affairs, Amsterdam, The Netherlands.
Transfusion. 2019 Feb;59(2):555-565. doi: 10.1111/trf.15065. Epub 2018 Dec 3.
Complications of donation reduce donor return. Younger and less experienced donors are more likely to experience vasovagal-type reactions (VVR). A water drink of approximately 500 mL shortly before donation may reduce VVR, but the effect of a smaller volume of water has not been investigated.
A placebo-controlled comparative study was conducted among donors < 30 years who attended for a 1st-4th whole blood (WB) donation. Collection centers were assigned to offer one of three interventions: 500 mL water drink, 330 mL water drink, or a placebo intervention consisting of pre-donation arm exercise. Within 7 days after attending, participants received an electronic questionnaire about possible symptoms during and after donation. In additional centers, control donors were recruited, who only received standard care and were also sent the questionnaire. Self-reported VVR and other complications were evaluated in all groups.
Out of 8,300 participating donors, 6,921 (83%) returned the questionnaire. Overall, 18.5% of responding donors reported moderate or worse VVR symptoms. In 2nd-4th time donors, both water volumes decreased the odds of a VVR compared to standard care controls (OR 0.75, 95% CI 0.59-0.94; OR 0.73, 0.58-0.91; adjusted combined OR 0.77, 0.64-0.94). There was no effect in new donors or the placebo group compared to controls.
In young donors making their 2nd-4th WB donation, drinking water was associated with 23% fewer VVR with no difference between 330 and 500 mL. This decrease was not found in the placebo group. The findings support advocating drinking water for the prevention of VVR.
献血相关并发症会降低献血者再次献血的意愿。年轻且经验较少的献血者更易出现血管迷走神经型反应(VVR)。献血前短时间饮用约500毫升水可能会减少VVR,但较小水量的效果尚未得到研究。
在年龄小于30岁、首次至第四次捐献全血(WB)的献血者中开展了一项安慰剂对照比较研究。采血中心被分配提供三种干预措施之一:饮用500毫升水、饮用330毫升水或进行献血前手臂运动的安慰剂干预。在参加献血后的7天内,参与者收到一份关于献血期间及献血后可能出现症状的电子问卷。在其他中心招募了仅接受标准护理且也收到问卷的对照献血者。对所有组的自我报告VVR及其他并发症进行评估。
在8300名参与的献血者中,6921名(83%)返回了问卷。总体而言,18.5%的回复献血者报告有中度或更严重的VVR症状。在第二次至第四次献血者中,与标准护理对照组相比,两种水量均降低了VVR的发生几率(比值比[OR]为0.75,95%置信区间[CI]为0.59 - 0.94;OR为0.73,0.58 - 0.91;调整后的合并OR为0.77,0.64 - 0.94)。与对照组相比,新献血者或安慰剂组未出现效果。
在进行第二次至第四次WB献血的年轻献血者中,饮水与VVR减少23%相关,330毫升和500毫升之间无差异。安慰剂组未发现这种减少情况。这些发现支持提倡饮水以预防VVR。