Reações vasovagais em doadores de sangue total: cenário de um estado da Amazônia brasileira

Abstract

Although blood donation is recognized as a very safe procedure, reactions of varying severity can occasionally occur during or after collection. This epidemiological, retrospective, crosssectional, descriptive, documentary study with a quantitative approach to data, is a pioneer in the state and aimed to analyze the occurrence of vasovagal reactions related to whole blood donation at the Institute of Hematology and Hemotherapy of Amapa. 2,155 records of reactions that occurred between 2014 and 2018 were analyzed. The data collection instrument addressed demographic and clinical aspects of the donor, type of donation and type of vasovagal reaction and associated factors according to the criteria of the blood donation process. Data were tabulated in an Excel spreadsheet and for processing and descriptive analysis expressed in relative and absolute values, mean and standard deviation presented in tables and graphs, the Statistical Package for Social Sciences version 22.0 program was used. Bivariate descriptive statistics were used using contingency tables and the Kolmogorov- Smirnov normality test, Pearson's chi-square test for categorical data analysis to assess the difference observed at random, adopting a significance level of 5%. To verify the association between the types of vasovagal reaction, demographic and clinical variables and associated factors identified, the Cramér association coefficient (V) was used. The incidence rate of vasovagal reactions was 3.1%, ranging between 2.4% and 3.8%; with a predominance of mild reactions (90.2%), more frequent in women (54.4%), aged between 30 and 40 years (33.8%). A statistically significant association was identified between milder reactions and lower Body Mass Index, between higher Estimated Blood Volume and lower severity of reactions, and between higher Systolic Blood Pressure and Diastolic Blood Pressure and lower severity of reactions; in addition to milder reactions in individuals with lower heart rate, but without statistical relevance, and no relationship between hematocrit rate and Vasovagal Reaction. First-time donors (63%) and those who performed targeted donation (70%) suffered more Vasovagal Reaction. Statistically significant relationships between prolonged fasting and poor hydration and the occurrence of reactions were also identified. It was concluded that the profile of Vasovagal Reactions in whole blood donors at the Blood Center of Amapa is similar to that identified in the literature, in most of the parameters evaluated. This study contributed to reaffirm the importance of the role of the professional team involved in the care of the donor throughout the blood cycle, especially in the clinical triage and donation room. It is expected that it can be a reference for analysis of prospective studies, considering the scarcity of studies on this topic in the Brazilian Amazon region, in addition to supporting the development of a protocol with measures to reduce adversity in donation, with a focus on improving clinical and care practices to this population with a profile more prone to reactions, mitigating the negative impacts of donation and encouraging the return of the donor.