Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 May;145(4):500-5.
doi: 10.1111/j.1365-2141.2009.07652.x. Epub 2009 Mar 5.

Haemoglobin oxygen saturation is a determinant of cerebral artery blood flow velocity in children with sickle cell anaemia

Charles T Quinn  1 , Jennifer Variste, Michael M Dowling
Affiliations

Haemoglobin oxygen saturation is a determinant of cerebral artery blood flow velocity in children with sickle cell anaemia

Charles T Quinn et al. Br J Haematol. 2009 May.

Abstract

Steady-state haemoglobin (Hb) desaturation is a common finding in sickle cell anaemia (Hb SS) that could predispose to stroke by limiting oxygen delivery to the brain. To determine its association with the risk of overt stroke, we examined the relationship between daytime Hb saturation measured by pulse oximetry (SpO(2)) and cerebral artery blood flow velocity measured by transcranial Doppler ultrasonography (TCD), an established risk factor for overt stroke in Hb SS. We studied 181 children using multivariate models to control for known determinants of TCD velocity, including age, haematocrit, and a measure of stenosis. We found that SpO(2) correlated significantly and inversely with TCD velocity in both the right and left middle cerebral arteries. Hb desaturation was associated with increased cerebral artery blood flow velocities and increased odds of abnormal TCD velocities, hence increased risk of stroke. About 5% of the variation in TCD velocity could be ascribed to Hb saturation while controlling for other determinants of TCD velocity. In conclusion, Hb saturation is a determinant of TCD velocity and a risk factor for stroke in children with Hb SS.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Correlation between Hb saturation and cerebral artery blood flow velocity (TAMMV)
Panels A and B show the correlations in the right and left middle cerebral arteries, respectively. Also shown are the regression line and its 95% confidence interval (dotted lines).
Figure 2
Figure 2. Receiver-operating characteristic (ROC) curves for the prediction of abnormal TCD velocities by Hb saturation
Panels A and B show the ROC curves for the prediction of abnormal TCD velocities (≥ 200 cm/s) in the right and left middle cerebral arteries, respectively, using a combination of Hb saturation, haematocrit, age, and a proxy measure of degree of stenosis as predictors. The x-axis indicates the false positive rate (1 – specificity). The y-axis indicates sensitivity (the proportion of patients who were correctly classified).
See this image and copyright information in PMC

References

    1. Adams R, et al. The use of transcranial ultrasonography to predict stroke in sickle cell disease. N Engl J Med. 1992;326:605–610. - PubMed
    1. Adams RJ, et al. Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial Doppler ultrasonography. N Engl J Med. 1998;339:5–11. - PubMed
    1. Gupta AK, et al. Thresholds for hypoxic cerebral vasodilation in volunteers. Anesth Analg. 1997;85:817–820. - PubMed
    1. Hargrave DR, et al. Nocturnal oxygen saturation and painful sickle cell crises in children. Blood. 2003;101:846–848. - PubMed
    1. Hogan AM, et al. Physiological correlates of intellectual function in children with sickle cell disease: hypoxaemia, hyperaemia and brain infarction. Dev Sci. 2006;9:379–387. - PubMed

Publication types

MeSH terms