A pilot study of continuous ambulatory monitoring of blood pressure in repeated preoperative autologous blood donation.
BACKGROUND
The aim of this study was to investigate the occurrence of hypotension in the 24-hour period after preoperative autologous blood donation (PABD) in patients with and without hypertension.


METHODS
In 20 patients, 24-hour ambulatory blood pressure monitoring (ABPM) was performed before PABD was started and on every donation day in two repeated phlebotomies.


RESULTS
Seven patients had no hypertension and 11 patients had hypertension. In 2 additional patients, hypertension was diagnosed during the study. Overall, the mean systolic BP (SBP) decreased from 131+/-15 mmHg before donation to 128+/-13 and 127+/-10 mmHg after Donations 1 and 2; the corresponding values for the diastolic BP (DBP) were 77+/-9, 75+/-9, and 73+/-7 mmHg, both without significant differences between the groups with and without hypertension. In single patients, substantial decreases of BP occurred, especially during the night. Two patients with and 2 without hypertension showed a nightly decrease in SBP and DBP of more than 10 percent (in 1 of these patients, more than 20%). Concerning diurnal BP variability, 1 patient with and 1 without hypertension, the latter showing a nightly decrease of SBP and DBP of more than 10 percent, also changed to the pattern of a nightly "extreme dipper" after PABD.


CONCLUSIONS
In 25 percent of the patients, changes of BP were observed during the 24-hour period after PABD, especially during the night, which are known to be associated with an increased risk of cerebral or myocardial ischemia. Whether those changes of BP lead to major morbidity or mortality requires further investigation.
Weisbach
Volker
V
Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, and the Klinikum Bamberg, Bamberg, Federal Republic of Germany. volker.weisbach@trans.imed.uni-erlangen.de
Schnabel
Lothar
L
Zimmermann
Robert
R
Zingsem
Jürgen
J
Eckstein
Reinhold
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D001804:Blood Transfusion, Autologous / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension; D007022:Hypotension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects