1 of 15

Are Bradycardic Donors More Likely to Have Adverse Outcomes During Blood Donation?

SN Ainulashikin binti Hamzah

Unit Kutipan Darah

2 of 15

INTRODUCTION�

In USA, a heart rate between 50-100 beats per minute (bpm) is a requirement for blood donor under Food and Drug Administration (FDA).

Data from the USA has shown that bradycardia and vasovagal reaction are unrelated.

Asymptomatic bradycardia is often due to intensive athletic training.

Investigating the safety of whole blood donation in bradycardic volunteers is essential to evidence-based practice.

Some institutions choose to defer donors with bradycardia. This effects donor return especially first time donor.

Blood donors in military settings tend to be younger and more physically fit than the average donor population, resulting in a higher percentage of bradycardic donors.

3 of 15

AIM OF STUDY

To compare post-donation adverse reaction and the

ability to complete donation between normocardic

and bradycardic donors in a military setting.

**All bradycardic donors were allowed donation upon physician

approvals.

4 of 15

Donor Information over 1 year period ( November 1^st ,2018 to October 31^st, 2019)
Retrospective study
Blood donor centre on a military installation
Inclusive data – all types of donation performed

at the centre

Exclusive data – deferred donor
Donor demographic, vital signs, Hb level and donor

status post-donation were examined.

In the USA, bradycardia was defined as a heart rate less

than 50 bpm and normocardic was defines as a heart rate

between 50 and 100 bpm.

METHOD AND MATERIALS STUDY

5 of 15

continue

A physician’s approval was required for bradycardic

donors to donate. The approval process was based on the subjective judgment of the physician.

All donors were monitored for a minimum of

30 minutes following donation to assist

and document in the event of a donor reaction.

6 of 15

RESULT�

Over 1 year , 1601 donor was recorded at the donor center
Donor were made up of active duty personnel, retirees, civilian government employees, and basic trainees.
87 donors excluded due to the criteria stated in methods. Total 1514 donors

Table 1

Basic Donor Demographic in All Donors, Regular Rate Donors, and Bradycardic Donors

7 of 15

RESULT�

Blood pressure was significantly lower in bradycardic donors compared to normocardic donors.
Donation duration time was longer with bradycardia donors.
There is no difference in hb level.

8 of 15

ADR : 3.63%

(out of 55 donors , only 2 donors with bradycardia had slight reaction- 1 VVR/1 hematoma )

COMPLETED : 96.37% (1459 donors)

Table 2 Reaction that occurred in donors

9 of 15

RESULT

From 1514 eligible donors, 1433 donors successfully completed donation.
Otherwise, 81 did not complete donations. Made up to 66 incomplete ( terminate) , 14 unsuccessful (cancel), and 1 overweight.
Bradycardic donors accounted for only 2 incomplete (terminated early)

10 of 15

discussion

In this study just 1:50 donors presented bradycardia
Based on normal cardiac physiology, it is likely these donors represented a healthier and more cardiovascular fit population.
The average time recorded to fill a bag was just under a minute longer than normocardic donors.
The occurrence of reaction was higher in the studied population because:
Hematoma was add on as a one type of reaction.
The study place was at military base – physically trained individuals

11 of 15

continue

The real number of bradycardic donors may be underappreciated in this study

Early morning donation involved donors directly from physical training
Repeat donor are aware for a physician approval for donation. These donors may perform cardiovascular intensive activities in order to qualify.

Many donor centers require physician approval for bradycardic donors.
Healthy donors (athlete or non athlete) who comes with lower heart rate are safe to donate.

12 of 15

conclusion

This study suggest that a healthy bradycardic donor is otherwise safe to donate..
No prior study have specifically examined the effect of bradycardia on reaction occurrence after donation.
If donors are deferred, it will reduce donor pool by over 2%
Further research is needed.

13 of 15

Pusat darah negara

**no research has ever been done

Our practise

blood pressure for donors

- accept if within the following range

systolic 100-150mmHg

diastolic 70-100mmHg

Pulse rate 60 -100bpm
Repeat donor – background ( history of previous donation )
1^st time donor – Vigilance the risk of ADR ( Applied Muscle Tension , adequate mineral water )

14 of 15

suggestion

Good practice for us to record pulse rate readings donor during pre-counseling as baseline data
Facilitate any research to be done
As baseline record comparison between pulse rate and blood pressure related to acute adverse donor reaction or delay adverse donor reaction.
From this practise we also can take care of the donor’s healthy indirectly