title: Serial assessment of laser Doppler flow during acute pain crises in sickle cell disease.
abstract: Changes in basal laser Doppler flowmetry (LDF) of skin blood flow in sickle cell disease are reported to have pathophysiologic relevance in pain crisis. This is the first study to strictly control for LDF variability in determining the value of serial, basal (unprovoked) skin LDF as a practical method to assess resolution of acute pain crisis in sickle cell patients. Daily LDF measurements were repeated on the exact same skin areas of the calf and forehead throughout each of 12 hospital admissions for uncomplicated acute pain crisis. A progressive increase in perfusion was observed in the calf throughout hospitalization as pain crisis resolved, but measurement reproducibility in the calf was poor. Reproducibility in the forehead was better, but no significant trend over time in perfusion was seen. There was no significant correlation between perfusion and pain scores over time. There was also no significant pattern of LDF oscillations over time. In conclusion, only perfusion units and not oscillatory patterns of LDF have probable pathophysiological significance in sickle cell disease vaso-occlusion. The reproducibility of basal skin LDF specifically in sickle cell disease needs to be confirmed.
authors.affiliation: Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA. Electronic address: pshi@nybloodcenter.org.
authors.forename: Patricia Ann
authors.initials: PA
authors.lastname: Shi
authors.affiliation: Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Bronx, NY 10467, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Manwani
authors.affiliation: University of Cincinnati Cancer Institute, 234 Goodman Street, Cincinnati, OH 45209, USA.
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Olowokure
authors.affiliation: New York Blood Center, 310 East 67th Street, New York, NY 10065, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Nandi
mesh_terms: D059787:Acute Pain / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005546:Forehead; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D015203:Reproducibility of Results; D012867:Skin / Q000098:blood supply*; D014953:Wrist
keywords: Acute pain crisis; Laser Doppler flowmetry; Microcirculation; Sickle cell disease