Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia.
Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia.
Transfusion. 2020 May;60(5):918-921. doi: 10.1111/trf.15701. Epub 2020 Feb 13.
A new national donor safety initiative was introduced in Australia in 2018, which aimed to encourage all whole blood donors to water load and to use applied muscle tension. This study evaluated the effect of this initiative on the rate of vasovagal reactions (VVR).
Routinely collected data were used to identify whole blood donations and any associated VVRs before (n = 167,056 donations) and after implementation (n = 215,572 donations). Multivariate logistic regression analyses were performed to evaluate the differences in VVR rates.
The total rate of VVRs declined from 22.5 per 1000 donations to 20.6 per 1000 donations after implementation, a reduction of 8% (p < 0.001). The rate of presyncopal reactions decreased by 8% in new donors and 12% in repeat donors. No impact was observed on the rate of syncope in any of the groups. The multivariate logistic regression analysis demonstrated the odds of experiencing a presyncopal reaction was reduced by 13% following implementation, with no significant effects on syncope.
The findings of this study support the use of water loading and applied muscle tension in routine whole blood collection to reduce the incidence of VVRs.
澳大利亚于 2018 年推出了一项新的国家供者安全计划，旨在鼓励所有全血供者进行水负荷和应用肌肉紧张。本研究评估了该计划对血管迷走性反应（VVR）发生率的影响。
使用常规收集的数据，在实施前（n=167056 次献血）和实施后（n=215572 次献血）分别识别全血献血和任何相关的 VVR。采用多变量逻辑回归分析评估 VVR 率的差异。
VVR 总发生率从实施前的每 1000 次献血 22.5 次降至实施后的每 1000 次献血 20.6 次，降低了 8%（p<0.001）。新供者的先兆晕厥反应率降低了 8%，重复供者降低了 12%。在任何一组中，都没有观察到晕厥的发生率有影响。多变量逻辑回归分析表明，实施后先兆晕厥反应的几率降低了 13%，而对晕厥没有显著影响。
本研究的结果支持在常规全血采集过程中使用水负荷和应用肌肉紧张来降低 VVR 的发生率。
