title: Prevention of syncopal-type reactions after whole blood donation: a cluster-randomized trial assessing hydration and muscle tension exercise.
abstract: BACKGROUND
  The prevention of presyncopal and syncopal reactions to whole blood donation is important for both the donor's safety and their retention as blood donors. The best strategy to achieve this remains debated.
  
  
  METHODS
  A prospective cluster-randomized trial comparing three hydration modes (500 mL of an isotonic drink, 500 mL of water, just before phlebotomy, or advice to drink [control arm]) coupled or not with light muscle tensing exercises, was carried out in mobile and fixed units of two regional blood centers in southeast France between January and July 2014. The main outcome was the cumulative incidence of presyncope (feeling faint) and syncope (fainting) at the donation site or in the 48 hours after leaving the site. Secondary outcomes were the cumulative incidence of these adverse events during donation, immediately after blood donation, or within 48 hours.
  
  
  RESULTS
  Overall, presyncope or syncope occurred in 5.5% of the 4576 donors. Compared to controls, drinking 500 mL (isotonic solution or water) significantly reduced the rate of events (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.55-0.99; p = 0.041) independently of muscle tensing exercise. Muscle tensing exercises significantly reduced syncopal-type reactions during the donation (OR, 0.64; 95% CI, 0.42-0.98; p = 0.041), and an isotonic drink significantly reduced delayed off-site syncopal-type reactions (OR, 0.62; 95% CI, 0.40-0.98; p = 0.040) and tiredness after donation (OR, 0.75; 95% CI, 0.59-0.94; p = 0.014).
  
  
  CONCLUSIONS
  Drinking 500mL of water or isotonic drink close to phlebotomy is useful in preventing presyncopal or syncopal reactions in blood donors. Isotonic drinks have the advantage of preventing delayed reactions and tiredness after whole blood donation.
authors.affiliation: Etablissement Français du Sang-Rhone-Alpes, Grenoble, France. chrystelle.morand@efs.sante.fr.
authors.forename: Chrystelle
authors.initials: C
authors.lastname: Morand
authors.affiliation: Etablissement Français du Sang, La Plaine Saint Denis, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Coudurier
authors.affiliation: TIMC-IMAG Université Grenoble Alpes.
authors.forename: Carole
authors.initials: C
authors.lastname: Rolland
authors.affiliation: TIMC-IMAG Université Grenoble Alpes.|INSERM CIC-1406, Grenoble, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Thoret
authors.affiliation: Etablissement Français du Sang-Rhone-Alpes, Lyon, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Legrand
authors.affiliation: UMR1098, INSERM, Etablissement Français du Sang, University of Franche-Comté, Besançon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tiberghien
authors.affiliation: TIMC-IMAG Université Grenoble Alpes.|INSERM CIC-1406, Grenoble, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bosson
mesh_terms: D000328:Adult; D001771:Blood Banks; D001782:Blood Donors; D004326:Drinking / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005221:Fatigue / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009129:Muscle Tonus / Q000502:physiology; D011446:Prospective Studies; D013575:Syncope / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D007552:Isotonic Solutions