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Multicenter Study
. 2009 Nov;147(3):352-9.
doi: 10.1111/j.1365-2141.2009.07854.x. Epub 2009 Aug 19.

Prospective evaluation of haemoglobin oxygen saturation at rest and after exercise in paediatric sickle cell disease patients

Andrew Campbell  1 , Caterina P Minniti, Mehdi Nouraie, Manuel Arteta, Sohail Rana, Onyinye Onyekwere, Craig Sable, Gregory Ensing, Niti Dham, Lori Luchtman-Jones, Gregory J Kato, Mark T Gladwin, Oswaldo L Castro, Victor R Gordeuk
Affiliations
Multicenter Study

Prospective evaluation of haemoglobin oxygen saturation at rest and after exercise in paediatric sickle cell disease patients

Andrew Campbell et al. Br J Haematol. 2009 Nov.

Abstract

Low steady state haemoglobin oxygen saturation in patients with sickle cell anaemia has been associated with the degree of anaemia and haemolysis. How much pulmonary dysfunction contributes to low saturation is not clear. In a prospective study of children and adolescents with sickle cell disease aged 3-20 years at steady state and matched controls, 52% of 391 patients versus 24% of 63 controls had steady state oxygen saturation <99% (P < 0.0001), 9% of patients versus no controls had saturation <95% (P = 0.008) and 8% of patients versus no controls had exercise-induced reduction in saturation > or =3%. Decreasing haemoglobin concentration (P < or = 0.001) and increasing haemolysis (P < or = 0.003) but not pulmonary function tests were independent predictors of both lower steady-state saturation and exercise-induced reduction in saturation. Neither history of stroke nor history of acute chest syndrome was significantly associated with lower steady-state oxygen saturation or exercise-induced reduction in saturation. Tricuspid regurgitation velocity was higher in patients with lower steady state haemoglobin oxygen saturation (P = 0.003) and with greater decline in oxygen saturation during the six-minute walk (P = 0.022). In conclusion, lower haemoglobin oxygen saturation is independently associated with increasing degrees of anaemia and haemolysis but not pulmonary function abnormalities among children and adolescents with sickle cell disease.

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Figures

Fig 1
Fig 1
Steady-state haemoglobin oxygen saturation in patients with sickle cell disease and controls. The steady state distribution of haemoglobin oxygen saturation in 391 children with sickle cell disease and 63 controls is depicted. Two hundred and two (52%) of the patients with sickle cell disease compared to 15 (24%) of the controls had haemoglobin oxygen saturation <99% while 9% of patients versus no controls had saturation <95% (P = 0·008).
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