Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India.
Transfus Med. 2024 Feb;34(1):20-29. doi: 10.1111/tme.13026. Epub 2024 Jan 2.
Vasovagal reaction (VVR) is a frequently encountered generalised donor adverse reaction, associated with donor deterrence towards future donation. Several mitigation strategies for prevention of VVR were tried but still not standardised. This quadri-armed randomised study evaluated the utility of water ingestion, applied muscle tension (AMT) and combination of both in preventing the VVR among blood donors.
A quadri-armed randomised controlled trial was performed on 4320 whole blood donors. Blood donors of 18-65 years of age were randomised into four groups based on the interventions performed i.e., control with no intervention (Group 1, n = 1081), water ingestion (Group 2, n = 1082), AMT (Group 3, n = 1070) and combined intervention (Group 4, n = 1087). VVR during and immediately after blood donation were observed along with assessment of risk factors in blood donors and the effectiveness of interventions were analysed.
The incidence of VVR observed 1.6% in our study, with the highest occurrence in the control group (2.5%) and the lowest in the combined intervention group (0.9%). Multivariable logistic regression revealed that the control group donors faced a 1.38-fold greater risk of VVR compared to those receiving interventions (OR: 1.38, 95% CI: 1.10-1.75). Other risk factors included younger age (OR: 1.5, 95% CI: 1.05-2.17), first-time donation (OR: 5.7, 95% CI: 1.66-5.74), prior history of VVR (OR: 2.5, 95% CI: 10.4-101.52).
DISCUSSION/CONCLUSION: The combined approach of water ingestion and AMT proved significantly more effective in VVR prevention compared to individual interventions.
血管迷走神经性反应（VVR）是一种常见的全身性供体不良反应，与供体对未来捐献的抵制有关。已经尝试了几种预防 VVR 的缓解策略，但仍未标准化。这项四臂随机研究评估了饮水、应用肌肉张力（AMT）和两者结合在预防献血者 VVR 中的效用。
对 4320 名全血献血者进行了四臂随机对照试验。18-65 岁的献血者根据所进行的干预措施随机分为四组，即无干预的对照组（第 1 组，n=1081）、饮水组（第 2 组，n=1082）、应用肌肉张力组（第 3 组，n=1070）和联合干预组（第 4 组，n=1087）。观察献血过程中和献血后即刻的 VVR，并评估献血者的危险因素，分析干预措施的有效性。
本研究中 VVR 的发生率为 1.6%，其中对照组发生率最高（2.5%），联合干预组发生率最低（0.9%）。多变量逻辑回归显示，与接受干预的组相比，对照组献血者发生 VVR 的风险高 1.38 倍（OR：1.38，95%CI：1.10-1.75）。其他危险因素包括年龄较小（OR：1.5，95%CI：1.05-2.17）、首次献血（OR：5.7，95%CI：1.66-5.74）、既往 VVR 史（OR：2.5，95%CI：10.4-101.52）。
讨论/结论：与单独干预相比，饮水和 AMT 的联合方法在预防 VVR 方面更有效。
