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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Sylvester
Karl P
KP
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.
Patey
Richard A
RA
Milligan
Peter
P
Rafferty
Gerrard F
GF
Broughton
Simon
S
Rees
David
D
Thein
Swee Lay
SL
Greenough
Anne
A
D000208:Acute Disease; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D001993:Bronchodilator Agents; D016022:Case-Control Studies; D002637:Chest Pain / Q000209:etiology*; D002648:Child; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D005334:Fever / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D012129:Respiratory Function Tests; D012720:Severity of Illness Index
D001993:Bronchodilator Agents