Page 31 - JSOM Spring 2025

Effects of Whole Blood Donation on
Physiological Responses and Physical Performance at Altitude

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Douglas M. Jones, PhD *; Nicholas Roberts, MD ; Rebecca S. Weller, MS ;
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Rebecca J. McClintock, MS ; Corey Buchanan ; Timothy L. Dunn, PhD 6

ABSTRACT
Background: The impact of single-unit blood donation (BD) BD. Physical performance decrements have been observed
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on donor physical performance at sea level is well-studied. following BD, albeit only during maximal exercise. 7
However, no studies have evaluated the impacts of BD on
warfighter performance at higher elevations. This study eval- Knowledge gaps exist regarding the effects of BD on combat
uated the effects of BD on high-altitude combat-load carry physical performance at high altitudes. No studies have exam-
performance in acclimatized military personnel following BD. ined the safety of high-altitude blood donation or evaluated the
Methods: Thirteen acclimatized military personnel (age: mean immediate impacts on donor physical abilities and physiology
28 [SD 6] years; height mean 175 [SD 7] cm; weight: mean of BD at high altitude. The aim of this study was to evaluate
78.4 [SD 9.1] kg; residence elevation 2,100m) completed two the effects of BD on donor performance of uphill combat load
3.2-km rucksack carries (mean 24.2 [SD 2.1] kg from 2800 to carries, or rucks, at high altitude in acclimatized personnel. We
3,050m, one without BD (control) and one after BD. Total ruck hypothesized that a slight reduction in oxygen-carrying capac-
march time, heart rate (HR), oxygen saturation (SpO ), respi- ity following BD combined with a reduction in oxygen avail-
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ratory rate (RR), minute ventilation (V ), rating of perceived ability in a high-altitude environment would increase time to
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exertion (RPE), thermal sensation (TS), and acute mountain complete a ruck march, ratings of perceived exertion (RPE),
sickness (AMS) symptoms were analyzed. Results: There were fatigue with associated physiological responses, and severity
no differences between control and BD for ruck march time of symptoms associated with acute mountain sickness (AMS).
(F (1,11) =2.13, P>.1, η2G=.03), HR (P>.1), RR (P>.1), V (P>.1), Findings from this study are critical to understanding military
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RPE (P>.1), and TS (P>.07). AMS symptoms were not im- operations performed in high-altitude environments, includ-
pacted by either condition. SpO was lower in the control sce- ing the safety of high-altitude BD and the expected physical
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nario than after BD (b=–4.23 [SE 2.4], P=.007). Conclusions: abilities of donor personnel during continued high-altitude
A single-unit whole blood donation does not impact donor operations.
physical performance in acclimatized participants during com-
bat-load carries at elevations up to 3,050m except with respect Methods
to SpO .
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Research Participants
Keywords: military; blood transfusion; elevation; exercise; The study population was based on a convenience sample of
performance; resource-limited settings military personnel participating in a military field training ex-
ercise. Thirteen active-duty military personnel stationed at a
military installation at 2,100m and enrolled in whole blood
transfusion recertification training volunteered to participate
Introduction
in the study (12 men, 1 woman; age: mean 28 [SD 6] years;
Fresh whole blood transfusion (FWBT) is the standard for re- height: mean 175 [SD 7] cm; weight: mean 78.4 [SD 9.1] kg. All
suscitation of hemorrhagic shock on the battlefield. A field participants operated daily at an elevation of at least 2100m
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blood transfusion requires one unit of whole blood from war- for at least 60 days prior to study commencement. Following
fighters who will need to continue executing combat opera- the dissemination of study details and procedures, participants
tions; thus, combatant commanders need to understand the provided voluntary informed consent per the Declaration of
impacts of blood donation (BD) on donors’ combat ability. Helsinki. The study was approved by the Institutional Review
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Multiple studies have examined the impact of single-unit do- Board at the Naval Health Research Center, San Diego, CA
nation on donor performance in combat readiness skills and (Protocol # NHRC.2021.0002).
operationally relevant physical fitness at sea level. These
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studies demonstrate minimal impact on marksmanship (100-m Study Design
sprint followed by shooting at a 50-m target in kneeling and As part of an FWBT exercise, participants performed uphill
prone positions) or aerobic (uphill 20-kg combat load carry), ruck marches in a high-altitude environment with (BD) and
anaerobic (200-m sprint), and cognitive (serial sevens subtrac- without (control) blood donation. The training schedule al-
tion test and ruler drop reaction time) performance following lowed for a counterbalanced research design; on the first day,
*Correspondence to Douglas Jones, Naval Health Research Center, 140 Sylvester Rd, San Diego, CA, 92106 or douglas.m.jones93.civ@health.mil
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1 Dr. Douglas M. Jones and Dr. Timothy L. Dunn are affiliated with the Warfighter Performance Department, Naval Health Research Center, San
Diego, CA. Dr. Nicholas Roberts and HM1 Corey Buchanan are affiliated with the Marine Corps Mountain Warfare Training Center, Bridge-
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port, CA. Rebecca S. Weller and Rebecca J. McClintock are affiliated with Leidos, Inc., San Diego, CA.
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