Interventions to reduce vasovagal reactions in blood donors: a systematic review and meta‐analysis
- 1 February 2016
- journal article
- review article
- Published by Wiley in Transfusion Medicine
- Vol. 26 (1), 15-33
- https://doi.org/10.1111/tme.12275
Abstract
Vasovagal reactions (VVRs) in blood donors have significant implications for the welfare of donors, donor retention and the management of donor sessions. We present a systematic review of interventions designed to prevent or reduce VVRs in blood donors. Electronic databases were searched for eligible randomised trials to March 2015. Data on study design and outcomes were extracted and pooled using random effects meta-analyses. Sixteen trials met the inclusion criteria: five trials (12 042 participants) of pre-donation water, eight trials (3500 participants) of applied muscle tension (AMT) and one trial each of AMT combined with water, caffeine, audio-visual distraction and/or social support. In donors receiving pre-donation water, the relative risk (RR) compared with controls for VVRs was 079 [95% confidence interval (CI) 070-089, P < 00001] and the mean difference (MD) in severity of VVRs measured with the Blood Donation Reactions Inventory (BDRI) score was -032 (95% CI -051 to -012, P < 00001). Excluding trials with a high risk of selection bias, the RR for VVRs was 070 (95% CI 045-111, P = 013). In donors who received AMT, there was no difference in the risk of chair recline in response to donor distress from controls (RR 076, 95% CI 053-110, P = 015), although the MD in BDRI score was -007 (95% CI -011 to -003, P = 00005). There was insufficient data to perform meta-analysis for other interventions. Current evidence on interventions to prevent or reduce VVRs in blood donors is indeed limited and does not provide strong support for the administration of pre-donation water or AMT during donation. Further large trials are required to reliably evaluate the effect of these and other interventions in the prevention of VVRs.Keywords
Funding Information
- NHS Blood and Transplant
- National Institute on Handicapped Research
This publication has 41 references indexed in Scilit:
- The influence of adverse reactions, subjective distress, and anxiety on retention of first-time blood donorsTransfusion, 2012
- Syncope after whole blood donation: factors associated with increased donor injuryTransfusion, 2012
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- Disgust, anxiety, and vasovagal syncope sensations: A comparison of injection-fearful and nonfearful blood donorsJournal of Anxiety Disorders, 2010
- Predonation hydration and applied muscle tension combine to reduce presyncopal reactions to blood donationTransfusion, 2010
- Donor complications and donor careISBT Science Series, 2009
- Social support attenuates presyncopal reactions to blood donationTransfusion, 2009
- The effect of a 473‐mL (16‐oz) water drink on vasovagal donor reaction rates in high‐school studentsTransfusion, 2007
- The effect of whole‐blood donor adverse events on blood donor return ratesTransfusion, 2006
- Donors who react may not come back: Analysis of repeat donation as a function of phlebotomist ratings of vasovagal reactionsTransfusion and Apheresis Science, 2005