Immediate effects of blood donation on physical and cognitive performance—A randomized controlled double-blinded trial

Eliassen, Håkon Skogrand; Hervig, Tor; Backlund, Sebastian; Sivertsen, Joar; Iversen, Vegard Vereide; Kristoffersen, Morten; Wengaard, Eivind Johannessen; Gramstad, Arne; Fosse, Theodor K.; Bjerkvig, Christopher; Apelseth, Torunn Oveland; Doughty, Heidi; Strandenes, Geir

doi:10.1097/ta.0000000000001917

Cited by 15 publications

(21 citation statements)

References 22 publications

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“…Blood donation did not affect changes in heart rate or systolic blood pressure and did not vary between the groups. Similar patterns were reported in a recent randomized, blinded controlled trial . These findings are not surprising as the loss of 450 cc of blood is equivalent to what is known as Class 1 shock, which is not expected to affect heart rate or blood pressure .…”

Section: Discussionsupporting

confidence: 85%

“…In a meta‐analysis published by Remoortel et al, blood donation resulted in lower hemoglobin levels, lower oxygen maximal uptake, and lower maximal exercise capacity in the first 2 days following blood donation. In a randomized controlled trial published by Eliassen et al a decline in maximal oxygen consumption was detected following blood donation in the test group. These changes were not demonstrated in the control group.…”

Section: Discussionmentioning

confidence: 92%

“…Most available data on patient function following blood donation are derived from nonrandomized, noncontrolled studies, and none report a noninferiority design . While these studies provide valuable information, they are subject to errors, limiting their applicability.…”

mentioning

confidence: 99%

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Cognitive and physical performance are well preserved following standard blood donation: A noninferiority, randomized clinical trial

et al. 2020

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BACKGROUND A walking blood bank (WBB) refers to the use of fellow combatants for battlefield blood donation. This requires pretesting combatants for infectious diseases and blood type. A fundamental prerequisite for this technique is that the donating soldier will suffer minimal physiological and mental impact. The purpose of the current study is to assess the effect of blood shedding on battlefield performance. METHODS This is a double‐blind randomized control trial. Forty Israel Defense Forces combatants volunteered for the study. Participants underwent baseline evaluation, including repeated measurement of vital signs, cognitive evaluation, physical evaluation, and a strenuous shooting test. Three weeks after the baseline evaluation, subjects were randomized to either blood donation or the control group. For blinding purposes, all subjects underwent venous catheterization for the duration of a blood donation. Repeated vital signs and function evaluation were then performed. RESULTS Thirty‐six patients were available for randomization. Baseline measurements were similar for both groups. Mean strenuous shooting score was 80.5 ± 9.5 for the control group and 82 ± 6.6 for the test group (p = 0.58). No clinically or statistically significant differences were found in tests designed to evaluate cognitive performance or physical functions. Vital signs taken multiple times were also similar between the test and control groups. CONCLUSIONS Executive, cognitive, and physical functions were well preserved after blood donation. This study supports the hypothesis that a WBB does not decrease donor combat performance. The categorical prohibition of physical exercise following blood donation might need to be reconsidered in both military and civilian populations.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 92%

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Cognitive and physical performance are well preserved following standard blood donation: A noninferiority, randomized clinical trial

et al. 2020

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“…Blood donation volume is often 450 mL, and several recent studies has shown that haemodynamic variables and physical and cognitive performance are well preserved in healthy male blood donors after an ordinary 450-mL donation. 15,16 However, larger donation volumes are used, for example, for apheresis. 3 In this study, there was no change in CBV as indicated by TI and plasma proANP following donation of 900 mL of blood, supporting the safety of donating more than 450 mL of blood in semi-recumbent healthy males.…”

Section: Discussionmentioning

confidence: 99%

The central blood volume as measured by thoracic electrical impedance and plasma proANP is not compromised by donation of 900 mL of blood in men

Gybel-Brask

Nordsborg

Goetze

et al. 2020

Transfusion Medicine

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Objectives: To evaluate whether the donation of 900 mL of blood reduces the central blood volume (CBV) assessed by thoracic electrical impedance (TI) and plasma pro-atrial natriuretic peptide (proANP). Background: Donation of 450 mL of blood carries a 1% risk of a vasovagal reaction. Withdrawal of 900 mL of blood decreases cardiac output; however, the effect on CBV remains unknown. Methods/Materials: A randomised, single-blinded, placebo-controlled, crossover design was used, where 21 healthy semi-recumbent men donated 2 × 450 mL blood or were sham-phlebotomised. Changes in CBV were estimated by proANP and TI at 1.5 (TI 1.5) and 100 (TI 100) kHz, reflecting extracellular volume and (regional) total body water, respectively, and the index value (IDX; 1/T 1.5-1/TI 100) was used to estimate changes in intracellular (red cell) volume. Systolic, diastolic and mean arterial blood pressure; heart rate; stroke volume; cardiac output; and systemic vascular resistance were monitored. After completion of the study, 1000 mL of isotonic saline was infused. Results: Changes (mean% ± SD) in TI 1.5 , TI 100 and IDX were similar after 450 mL (−0.2 ± 1.6%, 0.0 ± 1.1%, −0.4 ± 10.1%) and 900 mL (0.1 ± 1.6%, 0.2 ± 1.5% and −2.0 ± 15.8%) of blood donation compared to after a sham donation of 450 mL (−0.9 ± 1.2%, −0.5 ± 1.5% and −0.1 ± 6.1%) and 900 mL (−1.2 ± 1.5%, −0.6 ± 1.3% and 0.5 ± 9.9%). In addition, changes in plasma proANP were similar after 450 and 900 mL of blood donation (−0.8 ± 6.7% and −7.6 ± 7.9%) as after sham donations (1.3 ± 7.3% and −4.5 ± 5.6%). Monitoring haemodynamic variables revealed that stroke volume decreased after the donation of 900 mL of blood (−12 ± 12 mL) compared to sham donations. Conclusion: During a 900-mL blood loss in semi-recumbent men, CBV measured by TI and plasma proANP is not affected.

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“…However, these assumptions may not hold for isolated communities. Emergency donor panels may be used as part of the resilience plan . Stock holdings and resilience plans are based on risks, routine workload and logistics especially where blood needs to be redistributed.…”

Section: Future Directionsmentioning

confidence: 99%

Transfusion emergency preparedness for mass casualty events

Doughty

Rackham

2018

ISBT Science Series

Self Cite

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Transfusion emergency preparedness is increasingly being recognized as an important element in the healthcare response to mass casualty events (MCE). Planning should be designed to support an integrated response between the blood services and hospitals. The lessons identified from the Manchester Arena bombing in 2017 and recent incidents in London have led to new guidance. Demand planning has been informed by the global experience of civilian MCEs and the changing trends in trauma care. Past evidence suggests that only a modest number of hospitalized patients following MCEs require transfusion. The mean blood use per patient admitted is consistently calculated at 2–3 red cell units. Most blood is used within the first 6 h. However, a small number of critically injured with multi‐trauma may require massive transfusion and ongoing support. Many blood services have reported meeting the initial overall demand for blood from stock. However, universal components may be in short supply. The demand can be managed by pre‐agreed substitutions. Early transfusion triage enables the best use of hospital laboratory and blood service support. Careful communication with donor communities is essential to manage a controlled replenishment of stocks. Future challenges for the transfusion community include the trend towards lower red cell stock holdings and the changing trends in weapon use and tactics. A standardized approach to transfusion data collection is required to support future planning. The transfusion community is encouraged to plan for MCEs, contribute to ‘after action reviews’ and work together for safe and sustainable transfusion support.

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Immediate effects of blood donation on physical and cognitive performance—A randomized controlled double-blinded trial

Abstract: Randomized, controlled, double-blinded prospective trial study, level 1.

Cited by 15 publications

References 22 publications

Cognitive and physical performance are well preserved following standard blood donation: A noninferiority, randomized clinical trial

Cognitive and physical performance are well preserved following standard blood donation: A noninferiority, randomized clinical trial

The central blood volume as measured by thoracic electrical impedance and plasma proANP is not compromised by donation of 900 mL of blood in men

Transfusion emergency preparedness for mass casualty events

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