Hyperventilation as a Predictor of Blood Donation-Related Vasovagal Symptoms.
Journal
Psychosomatic medicine
ISSN: 1534-7796
Titre abrégé: Psychosom Med
Pays: United States
ID NLM: 0376505
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
pubmed:
17
3
2020
medline:
27
4
2021
entrez:
17
3
2020
Statut:
ppublish
Résumé
Most of the research on vasovagal reactions has focused on the contributions of cardiovascular activity to the development of symptoms. However, other research suggests that additional mechanisms like hyperventilation may contribute to the process. The goal of the present investigation was to examine the influences of cardiovascular and respiratory variables on vasovagal symptoms. This study was part of a randomized controlled trial investigating the effects of behavioral techniques on the prevention of vasovagal reactions in blood donors. Data from the no-treatment control group were analyzed. The final sample was composed of 160 college and university students. Observational and self-report measures of symptoms were obtained. Physiological variables were measured mainly using respiratory capnometry. Although respiration rate remained stable throughout donation, change in end-tidal carbon dioxide was associated with requiring treatment for a reaction during donation (odds ratio = 0.57, 95% confidence interval [CI] = 0.41 to 0.79, p = .001) and self-reported symptoms measured in the postdonation period using the Blood Donation Reactions Inventory (β = -0.152, 95% CI = -0.28 to -0.02, t = -2.32, p = .022). Individuals with higher levels of predonation anxiety displayed larger decreases in end-tidal carbon dioxide throughout the procedure (F(2,236) = 3.64, p = .043, ηp = 0.030). Blood Donation Reactions Inventory scores were related to changes in systolic (β = -0.022, 95% CI = -0.04 to -0.004, t = -2.39, p = .019) and diastolic blood pressure (β = -0.038, 95% CI = -0.06 to -0.02, t = -4.03, p < .001). Although the vasovagal reaction has traditionally been viewed as a primarily cardiovascular event, the present results suggest that hyperventilation also plays a role in the development of vasovagal symptoms.
Identifiants
pubmed: 32176193
doi: 10.1097/PSY.0000000000000800
pii: 00006842-202005000-00005
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
377-383Subventions
Organisme : CIHR
ID : MOP-133459
Pays : Canada
Références
Lewis T. A lecture on vasovagal syncope and the carotid sinus mechanism with comments on Gowers’s and Nothnagel’s syndrome. BMJ 1932;1:873–6.
Edwards MR, Benoit J, Schondorf R. Electrodermal activity in patients with neurally mediated syncope. Clin Auton Res 2004;14:228–32.
Heyer GL, Harvey RA, Islam MP. Sweat patterns differ between tilt-induced reflex syncope and tilt-induced anxiety among youth. Clin Auton Res 2016;26:295–302.
Struhal W, Mišmaš A, Kirchmayr M, Bartl S, Javor A, Vosko MR, Ransmayr G. Onset of sweating depends on the type of reflex syncope. Auton Neurosci 2014;184:73–6.
Heyer GL, Boles LH, Harvey RA, Cismowski MJ. Gastric myoelectrical and neurohormonal changes associated with nausea during tilt-induced syncope. Neurogastroenterol Motil 2018;30:e13220.
Ritz T, Wilhelm FH, Meuret AE, Gerlach AL, Roth WT. Do blood phobia patients hyperventilate during exposure by breathing faster, deeper, or both? Depress Anxiety 2009;26:E60–7.
Engel CL, Romano J. Studies of syncope; biologic interpretation of vasodepressor syncope. Psychosom Med 1947;9:288–94.
Ritz T, Meuret AE, Ayala ES. The psychophysiology of blood-injection-injury phobia: looking beyond the diphasic response paradigm. Int J Psychophysiol 2010;78:50–67.
Willie CK, Macleod DB, Shaw AD, Smith KJ, Tzeng YC, Eves ND, Ikeda K, Graham J, Lewis NC, Day TA, Ainslie PN. Regional brain blood flow in man during acute changes in arterial blood gases. J Physiol 2012;590:3261–75.
Brashear RE. Hyperventilation syndrome. Lung 1983;161:257–73.
Hornsveld H, Garssen B, van Spiegel P. Voluntary hyperventilation: the influence of duration and depth on the development of symptoms. Biol Psychol 1995;40:299–312.
Malmberg LP, Tamminen K, Sovijärvi AR. Orthostatic increase of respiratory gas exchange in hyperventilation syndrome. Thorax 2000;55:295–301.
Bass C, Gardner WN. Respiratory and psychiatric abnormalities in chronic symptomatic hyperventilation. BMJ 1985;290:1387–90.
Norcliffe-Kaufmann LJ, Kaufmann H, Hainsworth R. Enhanced vascular responses to hypocapnia in neurally mediated syncope. Ann Neurol 2008;63:288–94.
Folino AF. Cerebral autoregulation in neurally mediated syncope: victim or executioner? Heart 2005;92:724–6.
Ayala ES, Meuret AE, Ritz T. Confrontation with blood and disgust stimuli precipitates respiratory dysregulation in blood-injection-injury phobia. Biol Psychol 2010;84:88–97.
Ritz T, Meuret AE, Simon E. Cardiovascular activity in blood-injection-injury phobia during exposure: evidence for diphasic response patterns? Behav Res Ther 2013;51:460–8.
Ritz T, Wilhelm FH, Gerlach AL, Kullowatz A, Roth WT. End-tidal pCO2 in blood Phobics during viewing of emotion- and disease-related films. Psychosom Med 2005;67:661–8.
Harrison JM, Gilchrist PT, Corovic TS, Bogetti C, Song Y, Bacon SL, Ditto B. Respiratory and hemodynamic contributions to emotion-related pre-syncopal vasovagal symptoms. Biol Psychol 2017;127:46–52.
Mennitto S, Harrison J, Ritz T, Robillard P, France C, Ditto B. Respiration and applied tension strategies to reduce vasovagal reactions to blood donation: a randomized controlled trial. Transfusion 2019;59:566–73.
Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.
Ditto B, Wilkins J, France C, Lavoie P, Adler P. On-site training in applied muscle tension to reduce vasovagal reactions to blood donation. J Behav Med 2003;26:53–65.
France CR, Ditto B, France JL, Himawan LK. Psychometric properties of the Blood Donation Reactions Inventory: a subjective measure of presyncopal reactions to blood donation. Transfusion 2008;48:1820–6.
Cohen J, Cohen P, West SG, Aiken LS. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Mahwah, NJ: Lawrence Erlbaum Associates; 2002.
Trouern-Trend JJ, Cable RG, Badon SJ, Newman BH, Popovsky MA. A case-controlled multicenter study of vasovagal reactions in blood donors: influence of sex, age, donation status, weight, blood pressure, and pulse. Transfusion 1999;39:316–20.
Newman BH. Donor reactions and injuries from whole blood donation. Transfus Med Rev 1997;11:64–75.
Immink RV, Pott FC, Secher NH, van Lieshout JJ. Hyperventilation, cerebral perfusion, and syncope. J Appl Physiol (1985) 2014;16:844–51.
Nicholas T, Power J, Barr H. The pulmonary consequences of a deep breath. Respir Physiol 1982;49:315–24.
Ferris BG, Pollard DS. Effect of deep and quiet breathing on pulmonary compliance in man. J Clin Invest 1960;39:143–9.
Vlemincx E, Meulders M, Luminet O. A sigh of relief or a sigh of expected relief: sigh rate in response to dyspnea relief. Psychophysiology 2018;55:e12979.
Wuyts R, Vlemincx E, Bogaerts K, Van Diest I, Van den Bergh O. Sigh rate and respiratory variability during normal breathing and the role of negative affectivity. Int J Psychophysiol 2011;82:175–9.
Poh PY, Carter R, Hinojosa-Laborde C, Mulligan J, Grudic GZ, Convertino VA. Respiratory pump contributes to increased physiological reserve for compensation during simulated haemorrhage. Exp Physiol 2014;99:1421–6.
Convertino VA, Rickards CA, Lurie KG, Ryan KL. Hyperventilation in response to progressive reduction in central blood volume to near syncope. Aviat Space Environ Med 2009;80:1012–7.