Hypoxemia in sickle cell disease: significance and management.
Hypoxemia is common in SCD and likely exacerbates SCD vasculopathy. Pulse oximeter correlation with arterial oxygen tension in patients with SCD may at times be poor and arterial blood gas confirmation is required in hypoxic patients. Supplemental oxygen should be administered for the correction of hypoxemia, which if untreated creates a risk of multi-organ failure. Transfusion and hydroxyurea can improve oxygen delivery to tissues and organs. The role of supplemental oxygen therapy in preventing or reversing SCD vasculopathy is controversial. Nitric oxide therapy for VOC pain has not fulfilled promise to date. On the other hand, lung distension (CPAP, incentive spirometry, PEP therapy) are promising treatments requiring further study.
Division of Pediatric Pulmonology, Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, WA. Electronic address: jason.b.caboot.mil@mail.mil.
Jason B
JB
Caboot
Division of Pulmonary Medicine, Department of Pediatrics, University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.
Julian L
JL
Allen
D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000628:therapy*
Hypoxemia; Pediatrics; Sickle cell anemia