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Background and Objectives: Blood establishments strive to ensure the safety and comfort of blood donors while minimizing adverse events. This review aims to assess the efficacy and effectiveness of eating and/or drinking interventions before, during and/or after blood donation in reducing vasovagal reactions (VVRs). Materials and Methods: We analysed randomized and non‐randomized controlled trials comparing eating and/or drinking interventions to no intervention, placebo or usual practice on (pre‐)syncopal VVRs and related symptoms. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to assess the risk of bias and overall certainty of the evidence. Results: Pre‐donation water ingestion likely results in reduced on‐site VVRs, compared to no water (2 fewer per 100 donors, moderate‐certainty evidence). A pre‐donation isotonic drink likely results in reduced VVRs, compared to usual practice (2 fewer per 100 donors, moderate‐certainty evidence). Pre‐donation salt‐loaded sweetened lemon water may result in fewer off‐site VVRs, compared to sweetened lemon water only (1 fewer per 100 donors, low‐certainty evidence). Pre‐donation water and a gel cap containing sucrose with 250 mg caffeine may result in fewer blood donor reaction ratings, compared to pre‐donation water only (low‐certainty evidence). Conclusions: Pre‐donation plain water ingestion or isotonic drink probably results in a large reduction in on‐site and off‐site VVRs. Pre‐donation water ingestion with caffeine consumption or salt supplementation may result in a VVR reduction, compared to water ingestion only. Future large trials are required to increase the certainty of the effect of these and other interventions in the prevention of VVRs. [ABSTRACT FROM AUTHOR]

Background: Therapeutic phlebotomy (TP), a widely used medical procedure, can be performed on diverse patients with iron overload or polyglobulia. However, its adverse events are not well known as most of the information on phlebotomy is derived from healthy blood donors (0.1%–5.3%). In contrast, TP is applicable to a broader, more complex population with comorbidities and old age. To ascertain the incidence of adverse events in phlebotomies, we conducted a prospective study on patients who attended our Unit. Study Design and Methods: We prospectively gathered data from patients referred to our Unit for TP. Data regarding demographics, health status, and adverse events within at least 24 h of phlebotomy were gathered via a structured questionnaire during each visit. Results: Between August 2021 and September 2022, 189 patients underwent 587 procedures. Most patients were men, over 60 (57.3%) had comorbidities, and 93% underwent at least two procedures during the study period. Twenty patients (10.8%) presented 25 adverse events (4.3% of phlebotomies), usually vasovagal reactions, none of which were clinically relevant, and all were managed by nursing staff on site, with full patient recovery. Discussion: The rate of adverse events (<5%) in patients undergoing TP was low and comparable to that seen in healthy blood donors. Consequently, even old patients and those with some comorbidities can safely undergo TP when the process is carefully managed. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: 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. Methods: 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. Results: 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. [ABSTRACT FROM AUTHOR]

Background and Objectives: Vasovagal reactions (VVRs) are the most common adverse reactions and are frequently associated with serious donor adverse events. Even mild VVRs can lead to a significant reduction in the likelihood of subsequent donations. The purpose of this study is to explore the factors related to the occurrence of VVRs after plasma donation and to construct a nomogram to identify individuals at risk for VVRs to improve the safety of plasma donors. Materials and Methods: We collected the donation data from July 2019 to June 2020 from a plasma center in Sichuan, China, to explore the independent risk factors for vasovagal reactions. From these data, we constructed and validated a predictive model for vasovagal reactions. Results: VVRs after plasma donation occurred 737 times in 120 448 plasma donations (0.66%). Gender, season, donor status, weight, pulse, duration of donation, and cycle were independent risk factors for VVRs (P< 0.05). The concordance index (C‐index) of a logistic model in the derivation cohort was 0.916, with a Hosmer‐Lemeshow goodness‐of‐fit probability of 0.795. The C‐index of a logistic model in the validation cohort was 0.916, with a Hosmer‐Lemeshow goodness‐of‐fit probability of 0.224. The calibration curve showed that the predicted results were in good agreement with the actual observed results. Conclusion: This study preliminarily constructed and verified a prediction model for VVRs after plasma donation. The model nomogram is practical and can identify high‐risk donors. [ABSTRACT FROM AUTHOR]

Background: Vasovagal reactions (VVRs) are one of the primary reasons for people to stop donating blood. The aim of this study was to evaluate the impact of newly developed online communications on the rate of return of whole‐blood (WB) and plasma donors who experienced a VVR. Study Design and Methods: First‐time and experienced WB and plasma donors who had a VVR without a loss of consciousness in the previous 3 days were randomly allocated to receive (a) an SMS sent 1–4 days post‐VVR (n = 2303), (b) an email sent 6–10 days post‐VVR (n = 2360), (c) both the SMS and the email (n = 2248), or (d) business‐as‐usual donor retention communications (control; n = 2557). Donation data were extracted to determine subsequent donation attempts. Results: For return within 3 months, WB donors in the Email Only condition had significantly increased odds of returning (OR: 1.26, 95%CI: 1.01–1.56). Subgroup analysis within WB donors showed increased odds of return for women sent the SMS and Email (OR: 1.50, 95%CI: 1.14–1.96) or the Email Only (OR: 1.44, 95%CI: 1.10–1.89), and for first‐time donors sent the Email Only (OR: 1.48, 95%CI: 1.07–2.05). At 6 months, only first‐time WB donors in the Email Only condition had significantly increased odds of returning (OR: 1.30, 95%CI: 1.01–1.69). No significant effects of the intervention were found for immediate or intermediate return for plasma donors. Discussion: Sending an email addressing common donor concerns regarding VVRs increases WB donor retention, but additional strategies are needed for the effects to last and to retain plasma donors. [ABSTRACT FROM AUTHOR]

Abstract Background Prolonged dwelling time of inferior vena cava (IVC) filters has been shown to increase the need for the use of complex IVC filter retrieval techniques. In this report, we describe a case of complex retrieval of an IVC filter with prolonged dwelling time, which was temporarily accompanied by severe bradycardia and hypotension. Case presentation Fifty-nine-year-old male patient past medical history of morbid obesity, atrial fibrillation status post-ablation, obstructive sleep apnea, and end-stage renal disease presented for IVC filter retrieval 16 years after placement. When the IVC filter was covered by sheaths, and the IVC was temporarily collapsed and occluded, the patient developed severe bradycardia and hypotension without compensatory tachycardia. Contrast injection through the common femoral vein sheath showed complete occlusion of IVC while the IVC filter was covered by both sheaths, likely due to the embedment of the IVC filter in the wall by extensive fibrinous tissues. IVC filter was successfully retrieved, and the blood pressure and heart rate were improved immediately afterward. A large non-occlusive IVC thrombus was identified on the final venogram, which was aspirated using a mechanical thrombectomy device. Conclusion Complex retrieval of IVC filters with prolonged dwelled time can result in acute severe bradycardia and hypotension due to vasovagal reaction, acute collapse, and occlusion of IVC in the setting of IVC filter embedment in the wall by extensive fibrinous tissues.

Objective To explore the role and value of applied muscle tension (AMT) in preventing vasovagal nerve reaction (VVR) in blood donors. Methods A total of 2 992 people, susceptible to suffer VVR from May 2020 to may 2022, were randomly divided into control group (1406 cases) and observation group (1 586 cases). The control group was not given AMT intervention, while the observation group received AMT intervention at different periods during blood donation. The changes of systolic blood pressure, diastolic blood pressure, heart rate and psychological state of anxiety (self-rating anxiety scale, SAS) of blood donors were monitored in the two groups at each period to compare the occurrence of VVR. Results There were no statistically significant differences in blood pressure and heart rate between the two groups before blood donation (P>0.05). The parameters were relatively stable in observation group during and after donation, but significantly different from that of the controls(P>0.05). SAS score was similar in two groups before blood donation(P>0.05), while decreased in observation group during and after donation in comparison with the controls(P

Objective To explore the influencing factors and characteristics of blood donation-related vasovagal reactions in whole blood donation in Hefei city, and to put forward specific prevention measures. Methods Whole blood donors with vasovagal reactions related to blood donation in Hefei area from January 2021 to December 2021 were selected as the study subjects, and the related factors such as gender, age, blood donation month, initial or multiple blood donation, blood donation volume, blood donation location, and organization type of blood donation were retrospectively analyzed. Results The incidence of blood donation-related vasovagal reactions was 10.46‰ in the whole blood donation in Hefei in 2021, among which 71.89% occurred during blood collection. There were statistically significant differences in blood donation-related vasovagal reactions by blood donation age, blood donation history, blood collection month, organization type of blood donation and blood donation volume(P0.05). After balancing the age factors, there was no statistically significant difference in the incidence of DRVR between donors aged 18~22 and 23~29 years by gender(P>0.05), while there were significant differences in blood donors aged 30~39, 40~49, and 50~60 years by gender(P

When syncope or seizure-like activity occurs, nurses must act quickly to ensure patient safety. Medical-surgical nurses should be aware of differences between complex vasovagal reaction and new onset epilepsy so safe, effective interventions can be made quickly. Distinguishing new onset epilepsy from complex vasovagal syndrome requires the nurse to assess the immediate aftermath of the seizure-like activity. [ABSTRACT FROM AUTHOR]

IntroductionVasovagal reactions (VVRs) are common but complex donor adverse reactions (DAEs) in blood donations. VVRs have been extensively studied with a multitude of risk factors identified including young age, female gender and first-time donor status. How they may interplay remains obscure.MethodsA total of 1,984,116 blood donations and 27,952 immediate VVRs (iVVRs) and 1,365 delayed VVRs (dVVRs) reported between 2011 and 2021 in NZ were used in multivariate logistic regression analyses each concerning donations with iVVRs as cases and those free of DAEs as controls. For each analysis stepwise selection was used to identify the best model and risk factors carrying significant main effects and/or interactions. Identified interactions informed further in-depth regression analyses to dissect iVVR risk patterns.ResultsOver 95% of VVRs were iVVRs that had lower female preponderance and deferrals than dVVRs. iVVRs had a school seasonal pattern in whole blood donations driven by first-time donors from schools/colleges, and interactions between gender and age group differentiating the first-time from repeat donations. Subsequent regression analyses identified the known and novel risk factors of year and mobile collection sites and their interactions. iVVR rates were roundly elevated in 2020 and 2021 probably because of COVID-19 restrictions like facemask wearing. Exclusion of the 2020 and 2021 data removed the interactions with year, but confirmed interactions of gender with mobile collection sites (p = 6.2e-07) in first-time donations only and with age group in repeat donations only (p

Aims Syncope is a common and clinically challenging condition. In this study, the genetics of syncope were investigated to seek knowledge about its pathophysiology and prognostic implications. Methods and results This genome-wide association meta-analysis included 56 071 syncope cases and 890 790 controls from deCODE genetics (Iceland), UK Biobank (United Kingdom), and Copenhagen Hospital Biobank Cardiovascular Study/Danish Blood Donor Study (Denmark), with a follow-up assessment of variants in 22 412 cases and 286 003 controls from Intermountain (Utah, USA) and FinnGen (Finland). The study yielded 18 independent syncope variants, 17 of which were novel. One of the variants, p.Ser140Thr in PTPRN2 , affected syncope only when maternally inherited. Another variant associated with a vasovagal reaction during blood donation and five others with heart rate and/or blood pressure regulation, with variable directions of effects. None of the 18 associations could be attributed to cardiovascular or other disorders. Annotation with regard to regulatory elements indicated that the syncope variants were preferentially located in neural-specific regulatory regions. Mendelian randomization analysis supported a causal effect of coronary artery disease on syncope. A polygenic score (PGS) for syncope captured genetic correlation with cardiovascular disorders, diabetes, depression, and shortened lifespan. However, a score based solely on the 18 syncope variants performed similarly to the PGS in detecting syncope risk but did not associate with other disorders. Conclusion The results demonstrate that syncope has a distinct genetic architecture that implicates neural regulatory processes and a complex relationship with heart rate and blood pressure regulation. A shared genetic background with poor cardiovascular health was observed, supporting the importance of a thorough assessment of individuals presenting with syncope. [ABSTRACT FROM AUTHOR]

Background: Prolonged dwelling time of inferior vena cava (IVC) filters has been shown to increase the need for the use of complex IVC filter retrieval techniques. In this report, we describe a case of complex retrieval of an IVC filter with prolonged dwelling time, which was temporarily accompanied by severe bradycardia and hypotension. Case presentation: Fifty-nine-year-old male patient past medical history of morbid obesity, atrial fibrillation status post-ablation, obstructive sleep apnea, and end-stage renal disease presented for IVC filter retrieval 16 years after placement. When the IVC filter was covered by sheaths, and the IVC was temporarily collapsed and occluded, the patient developed severe bradycardia and hypotension without compensatory tachycardia. Contrast injection through the common femoral vein sheath showed complete occlusion of IVC while the IVC filter was covered by both sheaths, likely due to the embedment of the IVC filter in the wall by extensive fibrinous tissues. IVC filter was successfully retrieved, and the blood pressure and heart rate were improved immediately afterward. A large non-occlusive IVC thrombus was identified on the final venogram, which was aspirated using a mechanical thrombectomy device. Conclusion: Complex retrieval of IVC filters with prolonged dwelled time can result in acute severe bradycardia and hypotension due to vasovagal reaction, acute collapse, and occlusion of IVC in the setting of IVC filter embedment in the wall by extensive fibrinous tissues. [ABSTRACT FROM AUTHOR]

Background: Fear is a recognized predictor of vasovagal reactions (VVRs) in blood donors. However, less is known about the role of other emotions, including positive emotions, that donors might experience. The aim of this study was to identify the emotions experienced in center that predict onsite VVRs, and to determine at what point during the donation appointment, the experience of these emotions is most influential. Study design and methods: A sample of 442 first‐time whole‐blood donors (57.7% female; mean ± SD age 30.7 ± 11.7 years) completed a survey in the waiting area and before venepuncture in the donation chair to assess their current emotional experience. The survey data were matched with routinely‐collected demographic, donation, and donor adverse event information. A generalized estimating equations model was used to identify emotions associated with the occurrence of a VVR. Results: A total of 56 (12.7%) participants experienced a VVR. The occurrence of a VVR was significantly associated with lower love/closeness/trust (OR: 0.53, 95%CI: 0.34–0.82) and higher scared/fearful/afraid (OR: 1.96, 95%CI: 1.18–3.25) states. Significant interaction effects suggested that the effect of scared/fearful/afraid decreased while stressed/nervous/overwhelmed increased from the waiting area to before venepuncture on the likelihood of a VVR. Discussion: To effectively reduce donor VVR risk, blood collection agencies need to address a broader range of emotions at different points during the donation process. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors of vasovagal reactions(VVR) related to plasma donation, so as to put forward clinical suggestions for early identification and accurate intervention of high-risk groups to ensure the safety of plasma donation. Methods The demographic characteristics(i.e. gender, age, weight) and records of plasma donors(donation history, pulse before plasma donation, duration of collection, etc.) were collected from July to December 2019 in a region of Sichuan. Based on logistic regression analysis, the correlation between these factors and the risk of VVR was explored. Results The information of 69 172 donors was collected, and the incidence of VVR was 7.04‰. The risk of VVR was reduced by 99% in the group with plasma collection duration less than 30 minutes compared with the group with plasma collection duration more than 50 minutes(OR, 0.01; 95% CI, 0.00~0.01; P

BackgroundVasovagal reactions are common amongst patients with a fear of needles receiving injections or during venipuncture, but they are rarely studied in healthy people undergoing earlobe piercing. The purpose of this prospective study was to evaluate the incidence and the features of vasovagal reactions observed during earlobe piercing.MethodsThousand eight hundred and sixty six participants aged older than 13 years had their earlobes pierced in our department from January 2020 to January 2022. When vasovagal reactions occurred during the procedure (e.g., dizziness, pallor, diaphoresis, and faintness, etc.), they were recorded and more detailed demographic information was collected.ResultsA total of 196 cases of vasovagal reactions were reported in females amongst 1,866 participants, including 58 who actually lost consciousness during earlobe piercing. The incidence of vasovagal reactions and vasovagal syncope was 10.5 and 3.11% respectively. All syncopal reactions occurred in persons younger than 30 years.ConclusionVasovagal syncope is often very sudden and occurs without warning. Practitioners need to be familiar with these reactions, and prevent people from an unpredictable fall and subsequent injury during ear piercing.

Due to technological advancements in miniaturization of instruments and improved optics, the number of office hysteroscopic procedures has increased over time. Office hysteroscopy is preferred due to avoidance of general anesthesia and decreased overall cost. Vasovagal syncope has been implied as the most common complication. Vasovagal syncope is associated with inappropriate reflex vasodilation and bradycardia in the setting of an acute malfunction between the autonomic nervous system and the cardiovascular system; however, there is no mortality associated with vasovagal syncope. A management strategy for acute vasovagal reflex during office hysteroscopy is proposed in order to manage this common complication. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) vaccine administration started in February 2021 in Japan. As of December 2021, approximately 75% of the population aged ≥12 years had received two doses of vaccine. We conducted a study to investigate vasovagal reactions (VVR) after COVID-19 vaccination using data on adverse events following immunization. The crude reporting rate of VVR (cases/1,000,000 doses) after vaccination was 9.6 in all age groups combined, and was more frequent in the younger age groups: 28.6 and 37.2 in individuals aged 10–19 years and 20–29 years, respectively. In individuals aged 10–29 years, the rate was similar in males and females (33.0 and 34.2, respectively, p = 0.53); but was higher after dose 1 than after dose 2 (57.4 and 8.8, respectively, p < 0.001). Based on these results, caution needs to be exercised when vaccinating adolescents and young adults, especially with dose 1 of COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Background: To inform the development of interventions to retain donors following a vasovagal reaction (VVR), the aim of this study is to use the Health Action Process Approach (HAPA) to identify predictors of intentions to re-donate and actual return behavior among whole blood (WB) and plasma donors who experienced a VVR.Study Design and Methods: A total of 1136 WB donors (Mage  = 32.4 ± 12.5 years; 73.4% female) and 1141 plasma donors (Mage  = 36.5 ± 14.4 years; 73.3% female) completed an online survey after experiencing a VVR. Two hierarchical regression analyses were conducted for each donation type. In the first analysis, donation intentions were regressed onto the motivational HAPA constructs and social support. In the second analysis, donor return within 6 months was regressed onto social support, intentions, and the volitional HAPA constructs.Results: The motivational and social support variables accounted for 47.2% of the variance in intentions to return in WB donors and 15.7% in plasma donors. For both groups, task self-efficacy, positive and negative outcome expectancies, and social support were significant predictors of intentions to return. Intentions and action planning were significant predictors of donor return in both groups, and recovery self-efficacy was significant for plasma only.Conclusion: The HAPA model can provide guidance to blood collection agencies to design phase-specific and individually-focused interventions to retain WB and plasma donors following a VVR. [ABSTRACT FROM AUTHOR]

Vasovagal reactions are a benign but common outcome of interventional pain management procedures that can negatively impact patient care, including aborted procedures and fear of future procedures that would otherwise help the patient. Research has been done on the incidence, risk factors, and management of vasovagal reactions resulting from such procedures, but less is known about how to prevent these reactions from occurring. In this paper, we present a literature review of the pathophysiology, incidence, risk factors, prevention, and management of vasovagal reactions during interventional pain management procedures, with an emphasis on the relative lack of research and conflicting advice on preventive measures. We found that moderate sedation and anxiolytics have been used prophylactically to prevent vasovagal reactions, but their side-effect profiles prevent them from being used commonly. Less studied is the prophylactic administration of antimuscarinics and IV fluids, despite the potential benefit of these measures and relatively low side-effect profile. We explore these topics here and offer advice for future research to fill the gaps in our knowledge. [ABSTRACT FROM AUTHOR]

Abstract Background Corynebacterium urealyticum urinary tract infections can result in a rarely reported condition called encrusting cystitis whereby plaque lesions form on and within the urinary bladder mucosa. Chronic lower urinary tract signs manifest subsequent to the infection-induced cystitis and plaque-induced decreased bladder wall distensibility. Because of the organism’s multidrug resistance and plaque forming capability, infection eradication can be difficult. While systemic antimicrobial therapy is the mainstay of treatment, adjunctive surgical debridement of plaques has been used with relative paucity in such cases, thereby limiting our understanding of this modality’s indications and success rate. Consequently, this report describes the successful eradication of Corynebacterium urealyticum encrusting cystitis utilizing a unique timeline of medical and surgical treatments. Additionally, this represents the first reported veterinary case of a vasovagal reaction due to bladder overdistension. Case presentation A 6-year-old female spayed Miniature Schnauzer was evaluated for lower urinary tract clinical signs and diagnosed with Corynebacterium urealyticum encrusting cystitis. The infection was persistent despite prolonged courses of numerous oral antimicrobials and urinary acidification. A unique treatment timeline of intravenous vancomycin, intravesical gentamicin, and mid-course surgical debridement ultimately resulted in infection resolution. During surgery, while the urinary bladder was copiously flushed and distended with saline, the dog experienced an acute vasovagal reaction from which it fully recovered. Conclusions Surgical debridement of bladder wall plaques should be considered a viable adjunctive therapy for Corynebacterium urealyticum encrusting cystitis cases failing to respond to systemic antibiotic therapy. The timing in which surgery was employed in this case, relative to concurrent treatment modalities, may be applicable in future cases of this disease as dictated on a case-by-case basis. If surgery is ultimately pursued, overdistension of the urinary bladder should be avoided, or at least minimized as much as possible, so as to prevent the possibility of a vasovagal reaction.

Background: Vasovagal reactions (VVRs) are commonly experienced in medical situations such as blood donation. Many believe that psychosocial contagion can contribute to the development of VVRs, but this is largely clinical lore.Purpose: The goal of the present investigation was to examine the physiological effects of observing another experience a reaction, focusing on the potential moderating effects of empathy.Methods: This study was part of a randomized controlled trial of behavioral techniques on the prevention of VVRs in blood donors. The sample was composed of 530 healthy university students. Measures of symptoms were obtained with the Blood Donation Reactions Inventory (BDRI) and through observation. Physiological variables were measured using respiratory capnometry and a digital blood pressure monitor. The Affective and Cognitive Measure of Empathy was administered to 230 participants.Results: Donors who witnessed another experiencing a reaction were more likely to spontaneously report symptoms during the blood draw, to be treated for a reaction, to score higher on the BDRI, and to exhibit smaller compensatory heart rate increases. Donors with higher affective empathy reported more symptoms, exhibited hyperventilation, and were more likely to be treated. Donors with higher cognitive empathy were less likely to require treatment if they witnessed a reaction.Conclusion: These results suggest that psychosocial contagion of physical symptoms can occur. The moderating effects of empathy differed depending on the subtype of empathy. Perhaps a better cognitive understanding of how other people are feeling functions as a coping response, whereas feeling sympathetic about others' distress increases one's own. [ABSTRACT FROM AUTHOR]

Background and Objectives: The EPISoDe (Experience Success in Donation) study investigated the effect of interventions on self‐reported vasovagal reactions (VVRs) in first‐time and novice (second to fourth donation) whole blood donors aged ≤30 years, demonstrating a 23% reduction of VVR from water drinking shortly before donation in the novice donors. Because donation experience and complications affect donor retention, we analysed intervention group donors' return for subsequent donation, a predefined secondary outcome. Materials and Methods: The interventions were as follows: 330 ml water, 500 ml water, ball squeezing before phlebotomy (placebo) and a control group. All donors received an online questionnaire about their experience within a week after donation. In the Netherlands, eligible donors are invited at least yearly depending on hospitals' needs. We analysed attendances within 421 days through return percentages and binomial logistic regression. Results: Of the 8300 EPISoDe participants, 6538 (78.8%) returned within 421 days. Return did not differ between the two water groups, whereas odds for return were significantly higher in both water and placebo intervention donors compared to the control group (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.00–1.29 and 1.22, 1.05–1.43, respectively) after adjustment for occurrence of VVR, unsuccessful collection, gender and donation history. Staff‐recorded or self‐reported VVR at index donation was associated with reduced odds for return (OR 0.47, 95% CI 0.37–0.60 and OR 0.53, 95% CI 0.46–0.61, respectively). Conclusion: In this cohort of younger inexperienced blood donors, 78.8% returned for subsequent donation. Donors who received an active study intervention, either water or placebo, were more likely to return than control group donors. [ABSTRACT FROM AUTHOR]

Context: Whole blood donation is generally considered a safe procedure; however, a small percentage of donors could develop vasovagal reactions (VVRs) during or after completion of blood donation. Aims: This study was undertaken to establish the prevalence of VVR among whole blood donors in Hospital Pulau Pinang and to investigate factors that lead to its occurrence. Settings and Design: A cross-sectional study was conducted involving 27,890 whole blood donations in 2016. Subjects and Methods: For each donation, donor's demographic and blood donation-related information was extracted from the blood bank database. Statistical Analysis Used: Qualitative data including age group, sex, race, frequency, and location of donation were analyzed using Chi-square tests, while blood pressure was analyzed using t-test. Results: Overall, 425 cases of VVRs were reported, resulting in a VVR rate of 1.5% (one event in every 65 donations). We found a statistically significant association (P < 0.05) between the occurrence of VVRs with the young age group, female gender, Indian race, first-time donor, lower predonation blood pressure, and donation performed in a mobile donation campaign. The most common vasovagal symptoms are lightheadedness (88%), followed by nausea (5.4%), muscle twitching (3.5%), vomiting (1.4%), loss of consciousness

Introduction: The vasovagal reaction (VVR) incidence is the most common adverse donor reaction poses a major risk to the donor's safety and a disincentive for repeat donation. The main objective of this study is to determine the efficacy of applied muscle tension (AMT) in reducing the VVR incidence among young blood donors aged 18-23 years old in Kelantan. Methods: A prospective comparative interventional study was conducted among 306 young blood donors that were equally assigned to AMT and non-AMT groups. Donors were assessed with Blood Donation Reaction Inventory at 30 minutes and 48 hours post blood donation. The subjects were followed-up on whether they make at least one donation attempt in the next six months. Results: Out of 306 young blood donors, the incidence of VVR was 24.8%. The AMT group showed a significant reduction in the VVR incidence rate compared to the non -- AMT group (p<0.001). There was no significant increment of donor return among AMT group than non -- AMT group upon follow-up in six months. In addition, female (p=0.002), low body weight (p=0.002), low estimated blood volume (p=0.033) and low systolic blood pressure (p=0.005), are important predictors of VVR. Conclusion: This study showed that AMT was an effective strategy to reduce the VVR incidence among young blood donors in Kelantan. Implementation of AMT is recommended to donors with high risk of developing VVR. [ABSTRACT FROM AUTHOR]

Due to technological advancements in miniaturization of instruments and improved optics, the number of office hysteroscopic procedures has increased over time. Office hysteroscopy is preferred due to avoidance of general anesthesia and decreased overall cost. Vasovagal syncope has been implied as the most common complication. Vasovagal syncope is associated with inappropriate reflex vasodilation and bradycardia in the setting of an acute malfunction between the autonomic nervous system and the cardiovascular system; however, there is no mortality associated with vasovagal syncope. A management strategy for acute vasovagal reflex during office hysteroscopy is proposed in order to manage this common complication.

Introduction: A crucial component of the effort to meet the growing demand for blood is the recruitment and retention of young novice blood donors. Reducing postdonation syncopal reactions could have a beneficial impact on donor convenience, safety, and desire to donate again. Aim: To evaluate the effectiveness of predonation hydration over standard blood donation in the prevention or decrease in severity of postdonation Vasovagal Reactions (VVR) in hydrated blood donors in comparison with the non hydrated group. Materials and Methods: The randomised controlled trial was conducted on 953 first time voluntary blood donors. Donors in the intervention arm drank 250 mL water 30 minutes before blood donation, while those in the control group did not receive any intervention. Blood was collected by standard protocol. Outcome, VVR, if present was graded as mild, moderate, and severe. Analysis of results were done using Statistical Package for the Social Sciences (SPSS) version 16.0. A sensitivity analysis was also done to consider the dropouts from the study. Results: A total of 900 participants were included in the study, of which 443 were controls and 457 were cases. An effect size of 6.1%, a Relative Risk (RR) of 0.54 {95% Confidence Interval (CI)=0.36-0.81} and a risk reduction of 45% was arrived at, pointing to a protective role for predonation hydration in preventing VVR. There was a significant reduction in the severity of VVR in the predonation hydration group compared to the standard blood donation group (p-value=0.002). The protective effect of hydration on decreasing the occurrence and severity of VVR had statistical support in males in the moderate and severe grades (p-value=0.017). A similar statistical significance was not established in females (p-value=0.173). Sensitivity analysis did not reveal a difference in the statistical significance of variables between compared groups. Conclusion: Predonation hydration was found to be effective in preventing and decreasing the severity of VVR in novice blood donors.

Background: Corynebacterium urealyticum urinary tract infections can result in a rarely reported condition called encrusting cystitis whereby plaque lesions form on and within the urinary bladder mucosa. Chronic lower urinary tract signs manifest subsequent to the infection-induced cystitis and plaque-induced decreased bladder wall distensibility. Because of the organism's multidrug resistance and plaque forming capability, infection eradication can be difficult. While systemic antimicrobial therapy is the mainstay of treatment, adjunctive surgical debridement of plaques has been used with relative paucity in such cases, thereby limiting our understanding of this modality's indications and success rate. Consequently, this report describes the successful eradication of Corynebacterium urealyticum encrusting cystitis utilizing a unique timeline of medical and surgical treatments. Additionally, this represents the first reported veterinary case of a vasovagal reaction due to bladder overdistension. Case presentation: A 6-year-old female spayed Miniature Schnauzer was evaluated for lower urinary tract clinical signs and diagnosed with Corynebacterium urealyticum encrusting cystitis. The infection was persistent despite prolonged courses of numerous oral antimicrobials and urinary acidification. A unique treatment timeline of intravenous vancomycin, intravesical gentamicin, and mid-course surgical debridement ultimately resulted in infection resolution. During surgery, while the urinary bladder was copiously flushed and distended with saline, the dog experienced an acute vasovagal reaction from which it fully recovered. Conclusions: Surgical debridement of bladder wall plaques should be considered a viable adjunctive therapy for Corynebacterium urealyticum encrusting cystitis cases failing to respond to systemic antibiotic therapy. The timing in which surgery was employed in this case, relative to concurrent treatment modalities, may be applicable in future cases of this disease as dictated on a case-by-case basis. If surgery is ultimately pursued, overdistension of the urinary bladder should be avoided, or at least minimized as much as possible, so as to prevent the possibility of a vasovagal reaction. [ABSTRACT FROM AUTHOR]

Introduction: A crucial component of the effort to meet the growing demand for blood is the recruitment and retention of young novice blood donors. Reducing postdonation syncopal reactions could have a beneficial impact on donor convenience, safety, and desire to donate again. Aim: To evaluate the effectiveness of predonation hydration over standard blood donation in the prevention or decrease in severity of postdonation Vasovagal Reactions (VVR) in hydrated blood donors in comparison with the non hydrated group. Materials and Methods: The randomised controlled trial was conducted on 953 first time voluntary blood donors. Donors in the intervention arm drank 250 mL water 30 minutes before blood donation, while those in the control group did not receive any intervention. Blood was collected by standard protocol. Outcome, VVR, if present was graded as mild, moderate, and severe. Analysis of results were done using Statistical Package for the Social Sciences (SPSS) version 16.0. A sensitivity analysis was also done to consider the dropouts from the study. Results: A total of 900 participants were included in the study, of which 443 were controls and 457 were cases. An effect size of 6.1%, a Relative Risk (RR) of 0.54 {95% Confidence Interval (CI) =0.36-0.81} and a risk reduction of 45% was arrived at, pointing to a protective role for predonation hydration in preventing VVR. There was a significant reduction in the severity of VVR in the predonation hydration group compared to the standard blood donation group (p-value=0.002). The protective effect of hydration on decreasing the occurrence and severity of VVR had statistical support in males in the moderate and severe grades (p-value=0.017). A similar statistical significance was not established in females (p-value=0.173). Sensitivity analysis did not reveal a difference in the statistical significance of variables between compared groups. Conclusion: Predonation hydration was found to be effective in preventing and decreasing the severity of VVR in novice blood donors. [ABSTRACT FROM AUTHOR]

Vasovagal reactions are a benign but common outcome of interventional pain management procedures that can negatively impact patient care, including aborted procedures and fear of future procedures that would otherwise help the patient. Research has been done on the incidence, risk factors, and management of vasovagal reactions resulting from such procedures, but less is known about how to prevent these reactions from occurring. In this paper, we present a literature review of the pathophysiology, incidence, risk factors, prevention, and management of vasovagal reactions during interventional pain management procedures, with an emphasis on the relative lack of research and conflicting advice on preventive measures. We found that moderate sedation and anxiolytics have been used prophylactically to prevent vasovagal reactions, but their side-effect profiles prevent them from being used commonly. Less studied is the prophylactic administration of antimuscarinics and IV fluids, despite the potential benefit of these measures and relatively low side-effect profile. We explore these topics here and offer advice for future research to fill the gaps in our knowledge.

Background: Knowledge translation focuses on the transfer of research findings into policy and practice. To provide insight into the state of knowledge translation in blood donor research, we undertook a rapid review of a key research area in the field with high potential for translation, vasovagal reactions (VVRs). We examined the number and nature of VVR‐related studies to determine the availability of research evidence, and mapped the included articles along the research‐to‐practice trajectory using the Knowledge to Action framework. Study Design and Methods: PubMed, PsycINFO, CINAHL, and EMBASE were searched for peer‐reviewed journal articles from inception to October 2019 using the terms blood don* AND vasovagal OR faint* OR syncope. Results: A total of 176 articles met our inclusion criteria. Studies relating to VVRs increased substantially from 1942 to 2019, with 84% published in the last 20 years. Articles were predominately observation (non‐intervention) studies (117; 66%), followed by intervention (knowledge inquiry) studies (31; 18%) and review (knowledge synthesis) studies (20; 11%). The evidence from intervention research was limited, with 14 strategies tested in 31 studies and often by the same research groups. Only 5 (3%) implementation and evaluation studies were found; all focused on evaluating the effects of a newly introduced intervention on VVR rates through uncontrolled or cross‐sectional study designs. Discussion: VVR research is in the early stages of knowledge translation. More intervention research is needed to provide a robust evidence base as well as more published implementation research to share knowledge of translating research into policy and practice. [ABSTRACT FROM AUTHOR]

PurposeThis study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children.MethodsWe conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest.ResultsFourteen patients were identified. Of these, 13 were young children (

Background and Objectives To evaluate the possible effects of environmental surroundings on blood donor reactions, we analysed vasovagal reaction rates before and after renovation of the Yurakucho Blood Donation Center in Tokyo. Materials and Methods We conducted a retrospective cohort study based on data stored in a computerized database. The vasovagal reaction rates associated with blood donation during two separate 3-year periods were compared, that is prior to (October 2007 to September 2010) and after (October 2010 to September 2013) the renovation of the Yurakucho Blood Donation Center. The renovation included the following interventions: (1) expansion of the phlebotomy area from 188·0 to 322·4 m2 to accommodate 22 beds; (2) expansion of the reception/lounge area from 155·2 to 267·1 m2 with modification for a more relaxed atmosphere; and 3) addition of well-controlled air conditioning. Results The total reaction rate decreased from 0·65% (1302 reactions/200 181 donations) to 0·32% (606 reactions/191 966 donations) before and after the renovation, respectively, representing a 51% reduction (P < 0·001). During the pre-intervention period, reaction rates in winter were higher than those in other seasons, and the reaction rate was correlated with room temperature. It was also suggested that environmental factors other than room temperature might play an important role. Multivariate logistic regression analysis of risk factors demonstrated that the male gender was the strongest favourable factor and young age was the next to strongest favourable factor. Conclusion Our results suggest that providing a comfortable environment for blood donation may lead to fewer vasovagal reactions. [ABSTRACT FROM AUTHOR]

Context: Whole blood donation is generally considered a safe procedure; however, a small percentage of donors could develop vasovagal reactions (VVRs) during or after completion of blood donation. Aims: This study was undertaken to establish the prevalence of VVR among whole blood donors in Hospital Pulau Pinang and to investigate factors that lead to its occurrence. Settings and Design: A cross-sectional study was conducted involving 27,890 whole blood donations in 2016. Subjects and Methods: For each donation, donor's demographic and blood donation-related information was extracted from the blood bank database. Statistical Analysis Used: Qualitative data including age group, sex, race, frequency, and location of donation were analyzed using Chi-square tests, while blood pressure was analyzed using t-test. Results: Overall, 425 cases of VVRs were reported, resulting in a VVR rate of 1.5% (one event in every 65 donations). We found a statistically significant association (P < 0.05) between the occurrence of VVRs with the young age group, female gender, Indian race, first-time donor, lower predonation blood pressure, and donation performed in a mobile donation campaign. The most common vasovagal symptoms are lightheadedness (88%), followed by nausea (5.4%), muscle twitching (3.5%), vomiting (1.4%), loss of consciousness <30 s (1.4%), and paresthesia (0.2%). Conclusions: The prevalence of VVRs among whole blood donors in Hospital Pulau Pinang appeared to be low. Our study reaffirms that blood donation is a relatively safe process, and the incidence of VVR can be further reduced by ensuring strict screening procedure before blood donation. [ABSTRACT FROM AUTHOR]

Introduction: Increasing demand of platelet transfusions for patients has led to a trend in the increased use of automated blood collections. These share many of the same reactions and injuries seen with pooled platelets obtained from whole blood donation but also have unique complications. Aims And Objectives: To study the adverse events (AEs) of plateletpheresis procedure and their relationship with donor and plateletpheresis procedure session profiles. Materials And Methods: This is a retrospective observational study conducted from January 2016 to December 2016. A two-hundred and thirteen (213) plateletpheresis procedures were performed after taking informed and written consent from the donor. All the donors were male and selected according to the guidelines laid down by Director General of Health Services. The AEs were classified into donor related, kit/equipment related and technique related. Results: A total of 13 AEs were noted; of which, 8 (61.53 %) events were associated with donors, 3 (23.07 %) were owed to fault in kit/equipment and 2 (15.384 %) were due to technical aberrations. Donor related AEs included vascular injuries [n = 3 (1.40%)], vasovagal reactions [n = 2 (0.938%)] and perioral tingling sensation [n = 3 (1.40%)]. Technique related AEs [n = 2 (0.938%)] and kit/equipment related AEs [n = 3 (1.40%)] were due to faulty technique and defective kits respectively. Conclusion: Apheresis donations performed on cell separators are safe. Meticulous donor vigilance, superior technical personnel training and experienced transfusion medicine specialist's supervision will make donor's experience more pleasant.

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Objectives: Fragmented blood transfusion services along with an unmotivated blood donation culture often leads to blood shortage. Donor retention is crucial to meet the increasing blood demand, and adverse donor reactions have a negative impact on donor return. The aim of this study was to estimate adverse donor reactions and identify any demographic association. Methods: We conducted a prospective study between January 2011 and December 2013. A total of 41,759 healthy donors were enrolled. Professionally trained donor attendants drew blood and all donors were observed during and following donation for possible adverse events for 20 minutes. Blood donors were asked to report if they suffered from any delayed adverse consequences. Results: Out of 41,759 blood donors, 537 (1.3%) experienced adverse reactions. The incidence was one in every 78 donations. The mean age of donors who experienced adverse events was 26.0±6.8 years, and all were male. Out of 537 donors, 429 (80%) developed vasovagal reaction (VVR), 133 (25%) had nausea, 63 (12%) fainted, 35 (6%) developed hyperventilation, 9 (2%) had delayed syncope, and 9 (2%) developed hematoma. Arterial prick, nerve injury, cardiac arrest, and seizures were not observed. Donors aged less than < 30 years and weighing < 70 kg were significantly associated with VVR, hyperventilation, and nausea (p < 0.005). Undergraduates and Urdu speaking donors also had a significant association with fainting and nausea, respectively (p < 0.05). Conclusion: The prevalence of adverse events was low at our tertiary center. A VVR was the predominant adverse reaction and was associated with age and weight. Our study highlights the importance of these parameters in the donation process. A well-trained and experienced phlebotomist and pre-evaluation counseling of blood donors could further minimize the adverse reactions.

Background: Maintaining safe and adequate blood supply with minimal adverse events is the dual responsibility of all blood centres. Vasovagal reactions are of particular concern because they are relatively common, may cause injuries and are a rather important disincentive for subsequent donation. It is therefore, of utmost interest to identify those at risk. Method: This is a retrospective study of whole blood donations made in 2012–14. Chi‐square test, logistic regression and stratification are applied for statistical analysis. Result: Of 729,347 whole blood donations, vasovagal reactions occurred at 1·504%. Young age, first‐time donation, female and low body weight are important predictors and their adjusted odds ratios are 7·2 (age < 20 versus ≥50; 95% CI: 6·3, 8·3), 2·3 (first‐time versus repeat donors; 95% CI: 2·2, 2·4), 1·9 (female versus male; 95% CI: 1·8, 2·0) and 1·8 (weight < 50 kg versus ≥70 kg; 95% CI: 1·7, 2·0), respectively. This study also confirms that those with vasovagal reactions are much less likely to return with odds ratio of 4·4 (95% CI: 4·2, 4·6). Conclusion: As those with vasovagal reactions are significantly less likely to come back, it is recommended that high‐risk groups should be identified. The value of decreased vasovagal reactions would result in improved donor safety, higher donor satisfaction, better donor retention and potentially reduced costs. Application of risk reduction strategies should be implemented as part of the ongoing effort to contribute to more adequate and safer blood to be provided. [ABSTRACT FROM AUTHOR]