Preventing Adverse Reactions in Novice Blood Donors

描述（由申请人提供）：严重和潜在危险的血液供应短缺是常见的。随着人口老龄化（需求增加）和对献血者资格的越来越严格的限制（供应减少），这个问题预计会恶化。为满足日益增加的血液需求而作出的努力的一个关键组成部分是不断招募新的献血者。理想的情况是，新招募的人将成为终身献血者，每年献血6次，一生献血数百单位。不幸的是，只有不到一半的新手捐赠者会提供第二次捐赠。因为血管迷走神经反应的经历（例如，头晕、虚弱、头重脚轻）是新手献血者流失的最强预测因素之一，预防此类反应可能是增强国家血液供应的特别有效和持久的方法。我们的长期目标是为采血机构提供简单而廉价的策略，可用于预防血管迷走神经反应和增强供体保留。目前建议的具体目的是评估两种特别有前途的血管迷走神经预防策略的综合作用-水负荷和施加肌肉张力。我们将比较400名首次献血者对献血和重复献血行为的血管迷走神经反应，这些献血者被分配接受活性治疗（献血前水负荷和献血期间肌肉紧张）或安慰剂治疗（献血前肌肉紧张）。参与者将在美国红十字会在农村和城市的固定和移动的献血诊所招募和测试。将使用现场供体和采血师评级以及24小时后获得的供体评级测量血管迷走神经反应。使用美国红十字会国家捐赠者数据库，随后的捐赠历史将在两年的随访期内进行跟踪。我们假设，与安慰剂组的参与者相比，积极治疗组的参与者将经历更少的不良反应，并且更有可能返回提供新的捐赠。这项拟议中的研究测试了志愿献血者可以使用的简单策略，以防止负面反应，如昏厥，这往往会阻止献血者返回。我们工作的长期目标是通过提高献血者的积极性和对终身献血的承诺来解决血液供应经常性短缺的问题。由于我们直接与美国红十字会合作，我们的研究结果可以迅速转化为实践。

DESCRIPTION (provided by applicant): Severe and potentially dangerous shortages in the blood supply are common. This problem is expected to worsen as the population ages (increasing demand) and more and more stringent restrictions are placed on blood donor eligibility (decreasing supply). A crucial component of the effort to meet the increasing demand for blood is the ongoing recruitment of new donors. Ideally, new recruits would become lifelong donors, contributing up to six times per year and hundreds of units of blood in a lifetime. Unfortunately, less than half of all novice donors will ever provide a second donation. Because the experience of vasovagal reactions (e.g., dizziness, weakness, lightheadedness) is one of the strongest predictors of attrition in novice donors, prevention of such reactions may be a particularly efficient and enduring method of enhancing the nation's blood supply. Our long-term objective is to provide blood collection agencies with simple and inexpensive strategies that can be used to prevent vasovagal reactions and enhance donor retention. The specific aim of the current proposal is to evaluate the combined effects of two particularly promising vasovagal prevention strategies - water loading and applied muscle tension. We will compare vasovagal reactions to blood donation and repeat donation behavior in 400 first-time donors assigned to either active treatment (pre- donation water loading and muscle tensing during donation) or placebo treatment (pre-donation muscle tensing). Participants will be recruited and tested at American Red Cross fixed and mobile blood donation clinics held in rural and urban settings. Vasovagal reactions will be measured using on-site donor and phlebotomist ratings as well as donor ratings obtained 24 hours later. Using the American Red Cross national donor database, subsequent donation history will be tracked during a two-year follow-up period. We hypothesize that participants in the active treatment group will experience less adverse reactions and will be more likely to return to provide a new donation as compared to participants in the placebo group. The proposed study tests simple strategies that volunteer blood donors can use to prevent negative reactions, such as fainting, that frequently discourage donors from returning. The long term goal of our work is to address recurrent shortages in the blood supply by increasing donor motivation and commitment to lifelong giving. Because we are working directly with the American Red Cross, our findings can be quickly translated into practice.