Goal 1: Promote Human Health

Preventing hypotensive reactions and injury after blood donation

How can blood centers prevent hypotensive reactions after blood donation?

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Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Blood donation is generally safe and well tolerated by most individuals, but some people will experience syncopal reactions after donating blood, such as dizziness, lightheadedness, or loss of consciousness. Injuries which occur as a result of loss of consciousness after blood donation can rarely cause significant morbidity or disability. Although uncommon, such donation-related injuries are likely underreported because they often occur after the donor leaves the blood center. Published studies on interventions that reduce the risk of reactions have not shown an effect on preventing injuries, although some incidents might still be preventable. Physiologists have successfully treated syncope in patients with dysautonomia, in trained athletes, in astronauts, in pilots and others, using physical maneuvers with muscle tensing, to almost instantly increase venous return, cardiac output and cerebral perfusion. But studies on the use of physical maneuvers during blood donation have yielded conflicting results. Further efforts are needed to design, implement and monitor strategies to reduce injuries after blood donation and optimize donor health.

Feasibility and challenges of addressing this CQ or CC :

Injuries are most commonly associated with syncopal reactions which occur after the blood donor leaves the collection site and resumes normal daily activities. Reducing injuries will require identifying susceptible donors, providing them with postdonation instructions, and improving their ability to recognize prodromal symptoms and respond to orthostatic changes in blood pressure. Technology for personalized medicine platforms, such as mobile phone apps, could be developed to capture information about post-donation reactions and facilitate real-time interactions with blood donors. Such a system would also enable blood centers to design and deliver intervention and continuously monitor the effectiveness of the approach to prevent postdonation injuries.

Name of idea submitter and other team members who worked on this idea : Anne Eder MD PhD and Dana Devine PhD for the 2015 NHLBI State of the Science in Transfusion Medicine

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Idea No. 413