Please cite this article in press as: Deepika C, et al. Effect of pre-donation fluid intake on fluid shift from interstitial to intravascular compartment in blood donors. Transfus Apheresis Sci (2017), https://doi.org/10.1016/j.transci.2017.11.031 ARTICLE IN PRESS G Model TRASCI-2288; No. of Pages 4 Transfusion and Apheresis Science xxx (2017) xxx–xxx Contents lists available at ScienceDirect Transfusion and Apheresis Science j ourna l ho me page: www.elsevier.com/locate/transci Effect of pre-donation fluid intake on fluid shift from interstitial to intravascular compartment in blood donors Chenna Deepika a , Mohandoss Murugesan b,∗ , Shamee Shastry a a Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal University, Manipal, India b Department of Transfusion Medicine, Malabar Cancer Centre, Thalassery, India a r t i c l e i n f o Article history: Received 4 September 2017 Received in revised form 22 November 2017 Accepted 27 November 2017 Available online xxx Keywords: Fluid shift Blood Donors Blood Donation Donor Reactions Interstitial fluid a b s t r a c t Background: Fluid shifts from interstitial to intravascular space during blood donation helps in compen- sating the lost blood volume. We aimed to determine the volume of fluid shift following donation in donors with and without pre-donation fluid intake. Methods: We studied the fluid shift in 325 blood donors prospectively. Donors were divided in groups- with no fluid intake (GI) and either water (GII) or oral rehydrating fluids (GIII) before donation. Fluid shift following donation was calculated based on the difference between the pre and post donation blood volume. The influence of oral fluid intake, age, gender and body mass index (BMI) on volume of fluid shift was analyzed. Results: The fluid shift was significant between donors without fluids (GI: 127 ± 81 ml) and donors with fluid intake (GII & III: 96 ± 45 ml) (p < 0.05). The difference was not significant between donors with water intake (GII: 106 ± 52 ml) and oral rehydrating fluid intake (GIII: 87 ± 41 ml). The shifted fluid volume increased with increasing BMI and decreased with increasing age in females. The fluid shift increased in females than in males. Conclusion: The age, gender, BMI and VVR did not significantly contribute to the volume of fluid shift fol- lowing donation. As per our observation, the oral fluids before donation might not contribute to increase in fluid shift in blood donors after donation. © 2017 Elsevier Ltd. All rights reserved. 1. Background Blood donors in general tolerate the acute blood loss due to blood donation very well. Most blood donors compensate for this loss by various circulatory defense mechanisms. One of the princi- ple mechanisms acting immediately is by restoring the lost plasma volume by influx of fluid from interstitial to intravascular space to restore the plasma volume. Vasovagal reactions (VVR) in blood donors accounts for 53% of all adverse reactions noted; occurring at a frequency of less than 1% in blood donors [1,2]. Most donors with vasovagal reactions recover from it spontaneously within a moder- ate time except for few, who faint, fall or sustain an injury. Two most commonly followed interventions to reduce vasovagal reactions in blood donors were acute water loading and applied muscle tension [3]. Studies have shown that predonation water intake 30 minutes ∗ Corresponding author at: Department of Transfusion Medicine Malabar Cancer Centre, Thalassery Kannur Dt, Kerala, India. E-mail addresses: deepu.kkd@gmail.com (C. Deepika), drmohandossm@gmail.com (M. Murugesan), shameegirish@gmail.com (S. Shastry). before donation has lowered the risk of physiologic reactions to blood donation by preventing orthostatic hypotension and delayed the onset of presyncope reactions. It was also demonstrated that the salutary effects of hydration increased as the interval between water loading and phlebotomy decreased [3]. The pre donation fluid intake is noted to cause more fluids to shift from interstitial compartment to intravascular compartment and hence routinely practiced worldwide to prevent vasovagal reactions [4]. 2. Aim The aim of this study was to estimate the effect of pre-donation fluid intake on volume of fluid shift from the interstitial to intravas- cular compartment in blood donors. 3. Materials and methods We conducted a prospective study on 325 blood donors after obtaining permission from institutional ethics committee. Informed consent was obtained from all individual participants included in the study. Donors are divided into 3 groups and ran- https://doi.org/10.1016/j.transci.2017.11.031 1473-0502/© 2017 Elsevier Ltd. All rights reserved.