Impact of acute chest syndrome on lung function of children with sickle cell disease

Departments of Child Health, Health and Life Sciences, and Haematological Medicine, King's College London School of Medicine at Guy's, King's College, and St Thomas' Hospitals, London, United Kingdom.
Journal of Pediatrics (Impact Factor: 3.79). 08/2006; 149(1):17-22. DOI: 10.1016/j.jpeds.2005.12.059
Source: PubMed


To test the hypothesis that children with sickle cell disease (SCD) who experienced an acute chest syndrome (ACS) hospitalization episode would have worse lung function than children with SCD without ACS episodes.
Forced expiratory volume in 1 second (FEV(1)); forced vital capacity (FVC); FEV(1)/FVC ratio; peak expiratory flow (PEF); forced expiratory flow at 25% (FEF(25)), 50% (FEF(50)), and 75% (FEF(75)) of FVC; airway resistance (Raw); and lung volumes were compared in 20 children with ACS and 20 aged-matched children without ACS (median age, 11 years; range, 6 to 16 years). Fourteen age-matched pairs were assessed before and after bronchodilator use.
The mean Raw (P = .03), TLC (P = .01), and RV (P = .003) were significantly higher in the group with ACS than in the group without ACS. There were no significant differences in the changes in lung function test results in response to bronchodilator administration between the 2 groups, but the children with ACS had a lower FEF(25) (P = .04) and FEF(75) (P = .03) pre-bronchodilator use and a lower mean FEV(1)/FVC ratio (P = .03) and FEF(75) (P = .03) post-bronchodilator use.
Children with SCD who experienced an ACS hospitalization episode had significant differences in lung function compared with those who did not experience ACS episodes. Our results are compatible with the hypothesis that ACS episodes predispose children to increased airway obstruction.

12 Reads
  • Source
    • "310 Adults Historical controls TLC, RV, FVC, FEV 1 , FEV 1 /FVC, DLCO Akgul et al. (2006) [22] 48 Adults Healthy controls TLC, FVC, FEV 1 , FEV 1 /FVC, PEFR, DLCO Sylvester et al. (2006) [23] 40 Children (Hb-SS) Historical controls TLC, FRC, RV, RV/TLC, FVC, FEV 1 , FEV 1 /FVC, PEFR, FEF 50 , FEF 75 Ozbek et al. (2007) [24] 31 Children (Hb-SS) Historical controls FVC, FEV1, FEV1/FVC, FEF25-75 Koumbourlis et al. (2004) [25] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although some of the most severe complications of Sickle Cell Disease (SCD) tend to be acute and severe (e.g. acute chest syndrome, stroke etc.), the chronic ones can be equally debilitating. Prominent among them is the effect that the disease has on lung growth and function. For many years the traditional teaching has been that SCD is associated with the development of a restrictive lung defect. However, there is increasing evidence that this is not a universal finding and that at least during childhood and adolescence, the majority of the patients have a normal or obstructive pattern of lung function. The following article reviews the current knowledge on the effects of SCD on lung growth and function. Special emphasis is given to the controversies among the published articles in the literature and discusses possible causes for these discrepancies.
    Paediatric Respiratory Reviews 10/2013; 15(1). DOI:10.1016/j.prrv.2013.10.002 · 2.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The request scheduler carrying out the QoS provisioning with service differentiation was analysed for the wavelength-routed OBS network architecture. QoS performance for two traffic classes was analysed in terms of the burst blocking probability and end-to-end delays and as a function of the constraint of core wavelength over-provisioning. The results show that the WROBS is capable of a very efficient QoS performance, whilst significantly minimising the core wavelength requirement with regards to the statically-routed networks. It is demonstrated that the QoS provisioning for the premium traffic does not trade off the blocking probability of the best-effort traffic. Moreover, even with no core wavelength over-provisioning in WROBS, the desired blocking probability can be achieved for both premium and best-effort traffic whilst the delay bounds for both classes are not exceeded. The reported results are directly applicable for the provisioning of the guaranteed IP services and for RWA optimisation.
    Optical Fiber Communication Conference and Exhibit, 2002. OFC 2002; 04/2002
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sickle cell disease affects millions of people throughout the world. Acute chest syndrome is a major cause of illness and death in people with sickle cell disease. Symptoms include fever, chest pain and a raised white blood cell count. Acute infection of the lung tissue is a major cause of acute chest syndrome. Antibiotics are often given to treat these lung infections, but there is no worldwide standard treatment. We searched for randomised controlled trials which compared antibiotics (alone or in combination) with other antibiotics, placebo or standard treatment. We wanted to know if the different antibiotic treatments were effective, if they were safe, and which doses worked best for acute chest syndrome in people with sickle cell disease. This update was unable to find any trials to include in this review. We conclude that a randomised controlled trial should attempt to answer these questions. Until there is firm evidence, clinicians should treat acute chest syndrome on a case by case basis and according to the diagnosis and the treatment available.
    Cochrane database of systematic reviews (Online) 02/2007; 1(2):CD006110. DOI:10.1002/14651858.CD006110.pub2 · 6.03 Impact Factor
Show more

Similar Publications