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Transfusion and Apheresis Science :... Dec 2012Vasovagal reaction (VVR) is the most frequent side effect at blood collection sites.
BACKGROUND
Vasovagal reaction (VVR) is the most frequent side effect at blood collection sites.
AIMS
To protect donors, factors contributing to VVR were analysed.
MATERIALS AND METHODS
Complications following whole blood and apheresis donations have been recorded and accumulated by the Japanese Red Cross Tokyo Blood Centre. A dataset of 43,948 donors who had no complications was prepared as a control by randomly selecting days in each season in the 2006 and 2007 fiscal years. Factors contributing to 4924 VVR incidents in the 2006 and 2007 fiscal years were analysed by univariate and multivariate logistic regression.
RESULTS
The age, weight, body mass index (BMI), predonation systolic and diastolic pressure, and circulating blood volume were lower, and the pulse was higher, for the VVR group compared to the control group (p<0.0001). The VVR group had more female donors, less sleep, and more time since a meal than the control. In multivariate analysis, significant risk factors for 400 ml whole blood donors, which are the majority of donors, were an age <50 years, being female, a BMI <25, pulse ≥90/min, sleep duration <8 h, the time after eating ≥4 h, a first time donation and circulating blood volume of <4.3 l. Sleep duration of <6 h was shown to be a VVR risk as much as a first time donation.
CONCLUSION
From our analysis, the amount of sleep obtained the previous night should be considered at the reception of donors.
Topics: Adolescent; Adult; Blood Donors; Case-Control Studies; Female; Humans; Male; Risk Factors; Syncope, Vasovagal; Young Adult
PubMed: 22647682
DOI: 10.1016/j.transci.2012.04.002 -
Transfusion Jul 2011There have been multiple reports concerning the predictors of fainting reactions in blood donors, but few attempts to reduce the rates of fainting reactions with...
BACKGROUND
There have been multiple reports concerning the predictors of fainting reactions in blood donors, but few attempts to reduce the rates of fainting reactions with concomitant rigorous attempts to monitor the success of the interventions.
STUDY DESIGN AND METHODS
We used a retrospective observational cohort study design, comparing the likelihood of reaction from 213,031 allogeneic whole blood donations made by 17- to 22-year-old donors in two separate 12-month periods before and after the implementation of interventions to reduce reactions. The interventions were 1) a limit on the maximum percentage of estimated blood volume young donors could donate, 2) encouraging applied muscle tension during donation, and 3) providing approximately 500 mL of water before donation. Reactions were defined by severity and time in relation to the end of phlebotomy and documented according to standard procedures. Data analysis included comparison of stratified reaction rates and multivariable logistic regression analysis.
RESULTS
The interventions decreased the aggregate reaction rates in male and female donors by 24% (p < 0.0001). There was a 25% decrease in delayed reactions (p = 0.0006) and a 38% decrease in off-site reactions (p = 0.001) in female donors. The impact of the three interventions together on reaction rate was greater than the combined impact of exercises and water provision. Multivariable modeling showed that the interventions reduced reactions but did not prevent their occurrence in identified higher risk groups.
CONCLUSION
The interventions to reduce vasovagal reactions in whole blood donors were effective. Future efforts to reduce reactions in blood donors can build on the strengths and avoid the weaknesses identified while conducting and analyzing the data from this study.
Topics: Adolescent; Blood Donors; Cohort Studies; Exercise; Female; Humans; Male; Muscle Tonus; Retrospective Studies; Syncope, Vasovagal; Water; Young Adult
PubMed: 21382043
DOI: 10.1111/j.1537-2995.2011.03074.x -
Clinical Cardiology Jul 2023Vasovagal syncope (VVS) is the most prevalent type of syncope and its management includes pharmacologic and non-pharmacologic interventions. Recently, studies have... (Meta-Analysis)
Meta-Analysis Review
Vasovagal syncope (VVS) is the most prevalent type of syncope and its management includes pharmacologic and non-pharmacologic interventions. Recently, studies have investigated vitamin D levels in VVS patients. In this systematic review and meta-analysis, we aim to review these studies to find possible associations between vitamin D deficiency and vitamin D levels with VVS. International databases including Scopus, Web of Science, PubMed, and Embase were searched with keywords related to "vasovagal syncope" and "vitamin D." Studies were screened and the data were extracted from them. Random-effect meta-analysis was conducted to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for vitamin D levels in comparison to VVS patients and controls. Also, VVS occurrence was measured and the odds ratio (OR) and 95% CI were calculated for comparison of vitamin D deficient cases and nondeficient individuals. Six studies were included with 954 cases investigated. Meta-analysis showed that patients with VVS had significantly lower vitamin D serum levels in comparison to non-VVS cases (SMD -1.05, 95% CI -1.54 to -0.57, p-value < .01). Moreover, VVS occurrence was higher in vitamin D-deficient individuals (OR 5.43, 95% CI 2.40 to 12.27, p-value < .01). Our findings which show lower vitamin D levels in VVS patients can have clinical implications in order for clinicians to pay attention to this when approaching VVS. Further randomized controlled trials are certainly warranted to assess the role of vitamin D supplementation in individuals with VVS.
Topics: Humans; Tilt-Table Test; Syncope, Vasovagal; Syncope; Vitamin D Deficiency; Vitamin D
PubMed: 37226313
DOI: 10.1002/clc.24035 -
Archives Des Maladies Du Coeur Et Des... Mar 1998Most cases of dizziness or syncope referred to the emergency department or to services of internal medicine are caused by vasovagal syndromes. They comprise relative... (Review)
Review
Most cases of dizziness or syncope referred to the emergency department or to services of internal medicine are caused by vasovagal syndromes. They comprise relative bradycardia with vasoplegia, the cardiovascular response to a neurological stimulus. It is possible to distinguish vagal or vasovagal syncope which is very common, the very stereotype reflex syncopes, carotid sinus hypersensitivity sometimes associated with sinus node dysfunction and borderline forms such as orthostatic sinus tachycardia and cerebrovascular syncope. The differential diagnosis is vast, from simple hysteria to severe cardiac disease. Tilt testing should be indicated for diagnosis of most cases of syncope with apparently normal hearts. Therapeutic abstention is the rule, providing certain preventive measures are taken, but, should treatment be necessary, cardiac pacing remains an exceptional modality in vasovagal syncope. Strict clinical and physiopathological studies are still required to determine the long-term prognosis and the underlying mechanisms of these syndromes.
Topics: Cardiac Pacing, Artificial; Carotid Sinus; Diagnosis, Differential; Humans; Syncope, Vasovagal; Tilt-Table Test
PubMed: 9749283
DOI: No ID Found -
Europace : European Pacing,... Feb 2007Vavovagal syncope (VVS) is not generally associated with cardiovascular, neurological or other diseases, and, therefore, represents an isolated manifestation. Isolated...
Vavovagal syncope (VVS) is not generally associated with cardiovascular, neurological or other diseases, and, therefore, represents an isolated manifestation. Isolated VVS cannot be regarded as a disease for several reasons: spontaneous syncope occurs in about half of individuals during their lives, and the unidentified neural pathways involved in the vasovagal response are probably present in all healthy humans, with individual differences in susceptibility; VVS is induced during tilt testing in several subjects with no history of syncope; during haemorrhagic shock, the vasovagal reaction can be observed in subjects with no history of syncope; about 20% of astronauts, who are selected on the basis of their great resistance to orthostatic stress, experience syncope or presyncope on landing after a short-duration space flight; to date, no genetic basis of VVS has been demonstrated; subjects with VVS are generally normotensive and, importantly, have normal blood pressure regulation apart from the episodes of syncope; hormonal disorders or a generalized state of autonomic involvement, although frequently investigated, have never been clearly demonstrated. Isolated VVS should be distinguished from those forms that start in old age and which are often associated with cardiovascular or neurological disorders, and other dysautonomic disturbances such as carotid sinus hypersensitivity, post-prandial hypotension, and symptoms of autonomic dysfunction. In these subjects, VVS appears as an expression of a pathological process, i.e. a disease, mainly related to a generalized involvement of the autonomic nervous system, which is not yet well-defined from a nosological point of view.
Topics: Age Factors; Autonomic Nervous System; Disease Susceptibility; Humans; Risk Factors; Syncope, Vasovagal; Tilt-Table Test
PubMed: 17272328
DOI: 10.1093/europace/eul179 -
Cardiology Clinics Aug 2015Most strategies for managing syncope in children reflect data from studies involving the adult population. In the future, there will be a great need for studies in... (Review)
Review
Most strategies for managing syncope in children reflect data from studies involving the adult population. In the future, there will be a great need for studies in children and adolescents suffering from recurrent syncope. To date, there has been no Food and Drug Administration-approved therapy for neurocardiogenic syncope (NCS), the most common cause of syncope in both adults and children. None of the clinical trials of pharmacotherapy in NCS has shown benefit over placebo. NCS should be considered a chronic condition, and the aim of the therapy should be to decrease recurrence of syncope rather than to completely eliminate it.
Topics: Adolescent; Child; Disease Management; Humans; Incidence; Recurrence; Syncope, Vasovagal; Tilt-Table Test
PubMed: 26115826
DOI: 10.1016/j.ccl.2015.04.008 -
Europace : European Pacing,... Feb 2024
Topics: Humans; Syncope, Vasovagal; Pacemaker, Artificial; Cardiac Pacing, Artificial; Hemodynamics
PubMed: 38340323
DOI: 10.1093/europace/euae046 -
Nederlands Tijdschrift Voor Geneeskunde Mar 2022Although transient loss of consciousness (TLOC) is a common problem, hospital care for patients with TLOC is characterised by high rates of no diagnosis and...
Although transient loss of consciousness (TLOC) is a common problem, hospital care for patients with TLOC is characterised by high rates of no diagnosis and misdiagnosis, accompanied by unnecessary hospital admissions and tests. We attribute these problems to increasing specialisation as well as to a blind spot for vasovagal syncope, a condition not claimed by any specialty. We suggest that all doctors seeing patients with TLOC, both in primary and secondary care, should be familiar with the presentations of the relatively harmless vasovagal syncope and the alarm symptoms of potentially life-threatening cardiac syncope. In this article we present some practical pointers to recognise these conditions and answer some frequently-asked questions regarding the diagnosis and treatment of TLOC.
Topics: Humans; Physical Therapy Modalities; Syncope; Syncope, Vasovagal; Transients and Migrants; Unconsciousness
PubMed: 35499679
DOI: No ID Found -
Cardiology in the Young Oct 2014Postural tachycardia syndrome and vasovagal syncope are common causes of orthostatic intolerance in children. The supplementation with water, or salt, or midodrine, or... (Review)
Review
BACKGROUND
Postural tachycardia syndrome and vasovagal syncope are common causes of orthostatic intolerance in children. The supplementation with water, or salt, or midodrine, or β-blocker was applied to children with postural tachycardia syndrome or vasovagal syncope. However, the efficacy of such medication varied and was not satisfied. This review aimed to summarise the current biomarkers in the treatment of the diseases.
DATA SOURCES
Studies were collected from online electronic databases, including OVID Medline, PubMed, ISI Web of Science, and associated references. The main areas assessed in the included studies were clinical improvement, the cure rate, and the individualised treatment for postural tachycardia syndrome and vasovagal syncope in children.
RESULTS
Haemodynamic change during head-up tilt test, and detection of 24-hour urinary sodium excretion, flow-mediated vasodilation, erythrocytic H₂S, and plasma pro-adrenomedullin as biological markers were the new ways that were inexpensive, non-invasive, and easy to test for finding those who would be suitable for a specific drug and treatment.
CONCLUSION
With the help of biomarkers, the therapeutic efficacy was greatly increased for children with postural tachycardia syndrome and vasovagal syncope.
Topics: Adrenergic Antagonists; Biomarkers; Child; Fluid Therapy; Humans; Postural Orthostatic Tachycardia Syndrome; Syncope, Vasovagal; Tilt-Table Test; Vascular Resistance
PubMed: 24774832
DOI: 10.1017/S1047951114000316 -
Vox Sanguinis Apr 2024Risk factors for vasovagal reaction (VVR) have been extensively studied. With knowledge of the relative importance of these risk factors for VVR, collection staff could...
BACKGROUND AND OBJECTIVES
Risk factors for vasovagal reaction (VVR) have been extensively studied. With knowledge of the relative importance of these risk factors for VVR, collection staff could take care of blood donors from the same standpoint, leading to improved donor safety. We therefore developed a scoring system to predict VVR, which incorporates registration information.
MATERIALS AND METHODS
Pre-syncopal and syncopal symptoms, as well as on- and off-site reactions, are included in this analysis as VVR. We defined the donor status as follows: first-time donors, repeat donors with no history of reaction and repeat donors with a history of reaction. We prepared two datasets: whole-blood donations at a blood donation site in Tokyo between January 2019 and December 2019 were included in training data (n = 361,114), and whole-blood donations between January 2020 and August 2020 were included in testing data (n = 216,211).
RESULTS
The most important variable was the donor status, followed by age, estimated blood volume and height. We integrated them into a scoring system. Training and testing datasets were combined (n = 577,325), and VVR rates in groups with scores of 0, 1, 2, 3, 4 and 5 or more were 0.09% (95% CI: 0.081%-0.10%), 0.33% (95% CI: 0.31%-0.36%), 0.87% (95% CI: 0.78%-0.96%), 1.17% (95% CI: 1.05%-1.30%), 2.15% (95% CI: 1.98%-2.32%) and 3.11% (95% CI: 2.90%-3.34%), respectively.
CONCLUSION
The scoring system enables staff to significantly predict VVR and may help them to identify donors at increased risk of experiencing syncope, thereby mitigating the negative impact of VVR on donor safety and return by paying close attention to high-risk donors.
Topics: Humans; Blood Donation; Blood Donors; Syncope, Vasovagal; Risk Factors; Blood Volume
PubMed: 38156553
DOI: 10.1111/vox.13579