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. 2020 Jan 3;9(1):133.
doi: 10.3390/jcm9010133.

One-Fifth of Children with Sickle Cell Anemia Show Exercise-Induced Hemoglobin Desaturation: Rate of Perceived Exertion and Role of Blood Rheology

Valentine Brousse  1   2   3 , Corinne Pondarre  4 , Cecile Arnaud  4 , Annie Kamden  4 , Mariane de Montalembert  1   2 , Benedicte Boutonnat-Faucher  1 , Hélène Bourdeau  5 , Keyne Charlot  6 , David Grévent  7 , Suzanne Verlhac  8 , Lydie da Costa  2   3   5   9 , Philippe Connes  2   10   11
Affiliations

One-Fifth of Children with Sickle Cell Anemia Show Exercise-Induced Hemoglobin Desaturation: Rate of Perceived Exertion and Role of Blood Rheology

Valentine Brousse et al. J Clin Med. .

Abstract

Perceived exertion is an important self-limiting factor influencing functional capacity in patients with sickle cell anemia (SCA). Exercise-related hemoglobin desaturation (EHD) may occur during a six-minute walking test (6MWT) and could influence the perceived rate of exertion. The aims of this study were (1) to compare the 6MWT responses (heart rate, perceived rate of exertion, and distance covered) between SCA children with and without EHD, and (2) to test the associations between EHD and several biological/physiological parameters. Nine of 51 SCA children (18%) at steady state (mean age 11.9 ± 3.8 years) exhibited EHD at the end of the 6MWT. The rate of perceived exertion increased with exercise in the two groups, but reached higher values in the EHD group. Heart rate and performance during the 6MWT did not differ between the two groups. The magnitude of change in SpO2 during the 6MWT was independently associated with the red blood cell (RBC) deformability and RBC aggregates strength. This study demonstrates that SCA children with EHD during a 6MWT have a higher rate of perceived exertion than non-EHD children despite a similar physiological demand, and that abnormal RBC rheology determinants appear to be significant contributors.

Keywords: children; hypoxemia; sickle cell disease; six-minute walk test.

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Conflict of interest statement

The authors declare no conflict of interest.

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