Utility of impedance cardiography for the detection of hemodynamic changes in stable patients with sickle cell disease.
OBJECTIVE
The study sought to assess the potential utility of impedance cardiography (ICG) to detect hemodynamic changes after erythrocytapheresis in stable children with sickle cell disease (SCD).


METHODS
We prospectively monitored cardiac index, systemic vascular resistance index, heart rate, and blood pressure using ICG before and after erythrocytapheresis in 26 stable children with SCD. Echocardiography was carried out in all patients to evaluate left ventricular systolic function. Hemoglobin (Hb), sickle cell hemoglobin (HbS), and ferritin levels were also measured.


RESULTS
Of a total of 78 erythrocytapheresis procedures in 26 children with SCD, 22 (28.2%) had hypotensive episodes defined as a decrease in systolic, diastolic, or mean blood pressure by 10 mmHg. Risk factors for developing hypotension during erythrocytapheresis were identified with logistic regression analysis: lower-body surface area and decrease in cardiac index. In contrast, age, prepheresis Hb and HbS, serum ferritin levels, and left ventricular function at baseline were not associated with hypotension.


CONCLUSIONS
This study demonstrates the feasibility of the ICG technique to detect the hemodynamic changes in children with SCD after an erythrocytapheresis procedure.
Department of Pediatrics, Division of Pediatric Cardiology, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA. bdas99@hotmail.com
Bibhuti B
BB
Das
Ashok
A
Raj
Michael
M
Recto
Maiying
M
Kong
Salvatore
S
Bertolone
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D001830:Body Surface Area; D002302:Cardiac Output; D002307:Cardiography, Impedance / Q000379:methods*; D002648:Child; D016238:Cytapheresis; D005260:Female; D005293:Ferritins / Q000097:blood; D006439:Hemodynamics; D006801:Humans; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D016277:Ventricular Function, Left
D005293:Ferritins