Beneficial effects of nitric oxide breathing in adult patients with sickle cell crisis

C. Alvin Head, Paul Swerdlow, William A. McDade, Ratan Mani Joshi, Tohru Ikuta, Melanie L. Cooper, James R. Eckman

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Pain from vaso-occlusive crisis (VOC) is the major cause of hospitalization in patients with sickle cell disease (SCD). The beneficial therapeutic effects of inhaled nitric oxide (NO) on the pathophysiology of SCD have been reported. A double-blind, randomized, placebo-controlled clinical trial was conducted to determine whether NO breathing reduces acute VOC pain in adult patients and to study the safety of inhaled NO. Twenty-three patients experiencing acute VOC were enrolled. After randomization but before treatment, five were found to not meet final eligibility criteria. Nine patients were assigned to inhaled NO (80 ppm) and nine to placebo (21% O2). Primary outcome was the mean change in pain scores after 4 hr of inhalation, measured on a 10-cm visual analog scale (VAS). Both groups had similar baseline VAS pain scores but inhaled NO significantly reduced pain scores compared with placebo (P = 0.02) at the end of NO inhalation. Secondary outcome was parenteral morphine use at baseline, 4, and 6 hr. Parenteral morphine use was lower in the inhaled NO group, but the difference was not statistically significant. Safety assessments included systolic blood pressure measurements, pulse oximetry readings, concentration of delivered nitrogen dioxide, and concentration of methemoglobin (metHb). None of these NO toxicities was observed.

Original languageEnglish (US)
Pages (from-to)800-802
Number of pages3
JournalAmerican Journal of Hematology
Volume85
Issue number10
DOIs
StatePublished - Oct 2010

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Nitric Oxide
Respiration
Pain
Placebos
Sickle Cell Anemia
Morphine
Inhalation
Blood Pressure
Safety
Nitrogen Dioxide
Methemoglobin
Oximetry
Therapeutic Uses
Pain Measurement
Random Allocation
Visual Analog Scale
Reading
Hospitalization
Randomized Controlled Trials

ASJC Scopus subject areas

  • Hematology

Cite this

Head, C. A., Swerdlow, P., McDade, W. A., Joshi, R. M., Ikuta, T., Cooper, M. L., & Eckman, J. R. (2010). Beneficial effects of nitric oxide breathing in adult patients with sickle cell crisis. American Journal of Hematology, 85(10), 800-802. https://doi.org/10.1002/ajh.21832

Beneficial effects of nitric oxide breathing in adult patients with sickle cell crisis. / Head, C. Alvin; Swerdlow, Paul; McDade, William A.; Joshi, Ratan Mani; Ikuta, Tohru; Cooper, Melanie L.; Eckman, James R.

In: American Journal of Hematology, Vol. 85, No. 10, 10.2010, p. 800-802.

Research output: Contribution to journalArticle

Head, CA, Swerdlow, P, McDade, WA, Joshi, RM, Ikuta, T, Cooper, ML & Eckman, JR 2010, 'Beneficial effects of nitric oxide breathing in adult patients with sickle cell crisis', American Journal of Hematology, vol. 85, no. 10, pp. 800-802. https://doi.org/10.1002/ajh.21832
Head, C. Alvin ; Swerdlow, Paul ; McDade, William A. ; Joshi, Ratan Mani ; Ikuta, Tohru ; Cooper, Melanie L. ; Eckman, James R. / Beneficial effects of nitric oxide breathing in adult patients with sickle cell crisis. In: American Journal of Hematology. 2010 ; Vol. 85, No. 10. pp. 800-802.
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