Syncope, Vasovagal Clinical Trial
Official title:
Respiration and Applied Tension Strategies to Reduce Vasovagal Reactions to Blood Donation
For a number of years, researchers have examined the effects of the muscle-tensing
technique, Applied Tension (AT), on blood donation-related vasovagal symptoms and donor
retention. AT was developed originally to reduce symptoms and avoidance behaviour in people
with strong fears of blood and needles (phobics). It was based on the idea that
exercise-related increases in blood pressure might be able to counteract the effects of
stimuli that lead to a decrease in delivery of blood to the brain. AT was adapted for
non-phobic blood donors and significant reductions in self-reported vasovagal symptoms and
the need for nurse-initiated treatment as well as increases in donor retention were observed
in some groups.
That said, individual response to AT is quite variable. This is probably related to recent
research indicating that exercise-related maintenance of heart rate and blood pressure plays
only a minor role in reducing vasovagal symptoms. Rather, AT appears to be working at least
in part by regulating breathing and reducing the possibility of hyperventilation. Pilot
results suggest that a novel intervention aimed specifically at breathing may be more
effective and reliable than traditional AT. To evaluate this idea, 408 blood donors at
mobile clinics in colleges and universities will be assigned randomly to four conditions. In
brief, 5-minute preparation sessions using a notebook computer, donors will either learn a
respiration control technique to avoid hyperventilation, AT, both, or neither. As a
manipulation check and also a means of examining mechanisms of the interventions, e.g., the
possibility that AT may work by regulating breathing and CO2, participants will wear
non-invasive portable capnometers while they are giving blood. Outcome will also be assessed
by self-report of vasovagal symptoms, observational data, and number of return visits to a
blood clinic in the following year verified by the provincial blood collection agency,
Héma-Québec. As a secondary aim, the research will examine possible moderating effects of
pre-donation anxiety and sex.
The development of simple, effective approaches to reduce vasovagal symptoms during blood
donation has the potential to improve the blood donation experience and blood donor
retention as well as encourage people who have never given blood to consider the procedure.
It will also improve medical and dental care more generally given the use of needles in so
many procedures.
See above. ;
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