From the Department of Psychology (Mennitto, Ditto), McGill University, Montreal, Quebec, Canada; the Department of Psychology (Ritz), Southern Methodist University, Dallas, Texas; Héma-Québec (Robillard), Montreal, Quebec, Canada; and the Department of Psychology (France), Ohio University, Athens, Ohio.
Psychosom Med. 2020 May;82(4):377-383. doi: 10.1097/PSY.0000000000000800.
Most of the research on vasovagal reactions has focused on the contributions of cardiovascular activity to the development of symptoms. However, other research suggests that additional mechanisms like hyperventilation may contribute to the process. The goal of the present investigation was to examine the influences of cardiovascular and respiratory variables on vasovagal symptoms.
This study was part of a randomized controlled trial investigating the effects of behavioral techniques on the prevention of vasovagal reactions in blood donors. Data from the no-treatment control group were analyzed. The final sample was composed of 160 college and university students. Observational and self-report measures of symptoms were obtained. Physiological variables were measured mainly using respiratory capnometry.
Although respiration rate remained stable throughout donation, change in end-tidal carbon dioxide was associated with requiring treatment for a reaction during donation (odds ratio = 0.57, 95% confidence interval [CI] = 0.41 to 0.79, p = .001) and self-reported symptoms measured in the postdonation period using the Blood Donation Reactions Inventory (β = -0.152, 95% CI = -0.28 to -0.02, t = -2.32, p = .022). Individuals with higher levels of predonation anxiety displayed larger decreases in end-tidal carbon dioxide throughout the procedure (F(2,236) = 3.64, p = .043, ηp = 0.030). Blood Donation Reactions Inventory scores were related to changes in systolic (β = -0.022, 95% CI = -0.04 to -0.004, t = -2.39, p = .019) and diastolic blood pressure (β = -0.038, 95% CI = -0.06 to -0.02, t = -4.03, p < .001).
Although the vasovagal reaction has traditionally been viewed as a primarily cardiovascular event, the present results suggest that hyperventilation also plays a role in the development of vasovagal symptoms.
大多数关于血管迷走性反应的研究都集中在心血管活动对症状发展的贡献上。然而，其他研究表明，像过度通气这样的其他机制也可能对这一过程有贡献。本研究的目的是检验心血管和呼吸变量对血管迷走性症状的影响。
本研究是一项随机对照试验的一部分，该试验研究了行为技术对献血者预防血管迷走性反应的影响。对无治疗对照组的数据进行了分析。最终样本由 160 名大学生组成。通过观察和自我报告的症状测量，以及主要使用呼吸碳酸量测定法测量生理变量。
尽管在整个献血过程中呼吸频率保持稳定，但呼气末二氧化碳的变化与在献血过程中需要治疗反应有关（比值比=0.57，95%置信区间[CI]为 0.41 至 0.79，p=0.001），并且在献血后使用献血反应量表（BDRI）自我报告症状（β=-0.152，95%CI=-0.28 至-0.02，t=-2.32，p=0.022）。在整个过程中，预捐焦虑水平较高的个体呼气末二氧化碳的下降幅度更大（F（2，236）=3.64，p=0.043，ηp=0.030）。BDRI 评分与收缩压（β=0.022，95%CI=0.04 至 0.004，t=-2.39，p=0.019）和舒张压（β=0.038，95%CI=0.06 至 0.02，t=-4.03，p<0.001）的变化有关。
尽管血管迷走性反应传统上被视为主要的心血管事件，但本研究结果表明，过度通气也在血管迷走性症状的发展中起作用。
