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Conclusion 5. Strandenes G, Skogrand H, Spinella PC, Hervig T, Rein EB.
Donor performance of combat readiness skills of special forces
Findings suggest that a single unit BD has minimal impact on soldiers are maintained immediately after whole BD: a study
warfighter submaximal exercise performance or AMS risk in to support the development of a prehospital fresh whole blood
acclimatized personnel up to 3,050m. These findings are criti- transfusion program. Transfusion. 2013;53(3):526–530. doi:10.
1111/j.1537-2995.2012.03767.x
cal for combatant commanders and military medical providers 6. Nadler R, Tsur AM, Lipsky AM, et al. Cognitive and physical per-
to anticipate the impact of walking blood bank donations to formance are well preserved following standard blood donation:
donor warfighter combat effectiveness at altitude. a noninferiority, randomized clinical trial. Transfusion. 2020;60
Suppl 3:S77–S86. doi:10.1111/trf.15624
7. Panebianco RA, Stachenfeld N, Coplan NL, Gleim GW. Ef-
Acknowledgments fects of blood donation on exercise performance in competi-
The authors thank the Marine Corps Mountain Warfare Train- tive cyclists. Am Heart J. 1995;130(4):838–840. doi:10.1016/
ing Center, Mountain Medicine Department for their technical 0002-8703(95)90085-3
and logistical support for this study. 8. Peacock AJ. ABC of oxygen: oxygen at high altitude. BMJ. 1998;
317(7165):1063–1066. doi:10.1136/bmj.317.7165.1063
9. Williams N. The Borg Rating of Perceived Exertion (RPE) scale.
Author Contributions Occupational Medicine. 2017;67(5):404–405. doi:10.1093/occmed
DJ, RW, RM, NR, and CB designed the study. All authors ac- /kqx063
quired the data. DJ, RW, RM, and TD analyzed the data. DJ, 10. Koelblen B, Psikuta A, Bogdan A, Annaheim S, Rossi R. Thermal
RW, RM, TD, NR, and CB drafted and critically revised the sensation models: a systematic comparison. Indoor Air. 2017;27
(3):680–689. doi:10.1111/ina.12329
manuscript, and all authors approved the final version. 11. Kayser B, Aliverti A, Pellegrino R, et al. Comparison of a visual
analogue scale and ake Louise Symptom scores for acute moun-
Disclosures tain sickness. High Alt Med Biol. 2010;11(1):69–72. doi:10.1089/
ham.2009.1046
The authors have indicated they have no financial relation- 12. Bates D, Mächler M, Bolker B, Walker S. Fitting linear mixed-ef-
ships relevant to this article to disclose. fects models using lme4. Journal of Statistical Software. 2015;67
(1):1–48. doi:10.18637/jss.v067.i01
Disclaimer 13. Matuschek H, Kliegl R, Vasishth S, Baayen H, Bates D. Balanc-
One or more authors are military Servicemembers or employ- ing type I error and power in linear mixed models. Journal of
Memory and Language. 2017;94, 305–315. doi:10.1016/j.jml.
ees of the United States Government. This work was prepared 2017.01.001
as part of their official duties. Title 17, U.S.C. §105 provides 14. Burtscher M, Philadelphy M, Gatterer H, et al. Physiological re-
copyright protection under this title and is not available for any sponses in humans acutely exposed to high altitude (3480 m):
work outside of the U.S. Government. Title 17, U.S.C. §101 minute ventilation and oxygenation are predictive for the de-
defines U.S. Government work as work prepared by a military velopment of acute mountain sickness. High Alt Med Biol.
2019;20(2):192–197. doi:10.1089/ham.2018.0143
Servicemember or employee of the U.S. Government as part of 15. Howell ML, Coupe K. Effect of blood loss upon performance in
that person’s official duties. This work was supported by the the Balke-Ware treadmill test. Res Q. 1964;35:156–165.
Defense Health Agency (DHA) under work unit no. N2023. 16. Van Remoortel H, De Buck E, Compernolle V, Deldicque L,
Vandekerckhove P. The effect of a standard whole blood donation
on oxygen uptake and exercise capacity: a systematic review and
The views expressed in this article are those of the authors and meta-analysis. Transfusion. 2017;57(2):451–462. doi:10.1111/trf.
do not reflect the official policy or position of the Department 13893
of the Navy, Department of Defense, or the U.S. Government. 17. Walsh DJ, Palevo G, Polascik M, Slaton J. Physiological differ-
ences of US army cadets during a loaded and unloaded 6-mile ruck
march. Journal of Exercise Physiology Online. 2020;23(1):79–87.
The study protocol was approved by the Naval Health Re- 18. Wong DH, O’Connor D, Tremper KK, Zaccari J, Thompson P, Hill
search Center Institutional Review Board in compliance with D. Changes in cardiac output after acute blood loss and position
all applicable Federal regulations governing the protection of change in man. Crit Care Med. 1989;17(10):979–983. doi:10.1097/
00003246-198910000-00002
human subjects. Research data was derived from an approved 19. Pottgiesser T, Specker W, Umhau M, Dickhuth HH, Roecker K,
Naval Health Research Center (NHRC) Institutional Review Schumacher YO. Recovery of hemoglobin mass after blood do-
Board protocol, number NHRC.2021.0002. nation. Transfusion. 2008;48(7):1390–1397. doi:10.1111/j.1537-
2995.2008.01719.x
Funding 20. Stangerup I, Kramp NL, Ziegler AK, Dela F, Magnussen K,
This work was supported by the Defense Health Agency Helge JW. Temporary impact of blood donation on physical
performance and hematologic variables in women. Transfusion.
(DHA) under work unit no. N2023. All materials used in the 2017;57(8):1905–1911. doi:10.1111/trf.14121
study were purchased by the Naval Health Research Center 21. Hill DW, Vingren JL, Burdette SD. Effect of plasma donation and
with DHA funds. blood donation on aerobic and anaerobic responses in exhaustive,
severe-intensity exercise. Appl Physiol Nutr Metab. 2013;38(5):
551–557. doi:10.1139/apnm-2012-0361
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