Sequential nitric oxide measurements during the emergency department treatment of acute vasoocclusive sickle cell crisis

• Published in: American journal of hematology 2000-05, Vol.64 (1), p.15-19
• Main Authors: Lopez, Bernard L., Davis‐Moon, Linda, Ballas, Samir K., Ma, Xin‐liang
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Analgesics - therapeutic use; Anemia, Sickle Cell - blood; Anemia, Sickle Cell - drug therapy; Anemia, Sickle Cell - physiopathology; Anemias. Hemoglobinopathies; Biological and medical sciences; Biomarkers; Diseases of red blood cells; Hematologic and hematopoietic diseases; Humans; Medical sciences; nitric oxide; Nitric Oxide - blood; pain; Pain - blood; Pain - drug therapy; Predictive Value of Tests; sickle cell anemia; Tropical medicine
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/(SICI)1096-8652(200005)64:1<15::AID-AJH3>3.0.CO;2-P

This prospective study was designed to examine the relationship between serial serum nitric oxide (NO) levels and pain during the emergency department (ED) treatment of acute vasoocclusive sickle cell crisis (SCC). 102 patient visits, age ≥18 years of age, presenting to the ED with uncomplicated, typical SCC pain had serum NO levels obtained at 2‐hr intervals during treatment of pain and were measured using an NO‐specific chemiluminesence technique. Pain was measured prior to each NO measurement using a 10 cm visual analog scale (VAS), and subjects were divided into a persistent pain group and an improved pain group. Patients with persistent pain had significantly low initial NO levels (11.51 μM ± 2.8, P < 0.05) while those with pain improvement had higher initial NO levels (18.1 μM ± 3.08, P < 0.05). There was no significant correlation between changes in NO and changes in pain scores. These results suggest that the initial NO level may serve as a marker for the severity of tissue ischemia. Sequential NO levels do not appear useful in predicting the course of SCC. Am. J. Hematol. 64:15–19, 2000. © 2000 Wiley‐Liss, Inc.