Microvascular oxygen consumption during sickle cell pain crisis

• Published in: Blood 2014-05, Vol.123 (20), p.3101-3104
• Main Authors: Rowley, Carol A., Ikeda, Allison K., Seidel, Miles, Anaebere, Tiffany C., Antalek, Matthew D., Seamon, Catherine, Conrey, Anna K., Mendelsohn, Laurel, Nichols, James, Gorbach, Alexander M., Kato, Gregory J., Ackerman, Hans
• Format: Article
• Language: English
• Subjects: Acute Pain - complications; Acute Pain - metabolism; Acute Pain - pathology; Adult; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - metabolism; Anemia, Sickle Cell - pathology; Arterial Occlusive Diseases - complications; Arterial Occlusive Diseases - metabolism; Arterial Occlusive Diseases - pathology; Brachial Artery - metabolism; Brachial Artery - pathology; Brief Report; Clinical Trials and Observations; Female; Humans; Inflammation - complications; Male; Microvessels - metabolism; Microvessels - pathology; Middle Aged; Oxygen - metabolism; Oxygen Consumption; Pain
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2013-11-533406

Sickle cell disease is an inherited blood disorder characterized by chronic hemolytic anemia and episodic vaso-occlusive pain crises. Vaso-occlusion occurs when deoxygenated hemoglobin S polymerizes and erythrocytes sickle and adhere in the microvasculature, a process dependent on the concentration of hemoglobin S and the rate of deoxygenation, among other factors. We measured oxygen consumption in the thenar eminence during brachial artery occlusion in sickle cell patients and healthy individuals. Microvascular oxygen consumption was greater in sickle cell patients than in healthy individuals (median [interquartile range]; sickle cell: 0.91 [0.75-1.07] vs healthy: 0.75 [0.62-0.94] −ΔHbO2/min, P < .05) and was elevated further during acute pain crisis (crisis: 1.10 [0.78-1.30] vs recovered: 0.88 [0.76-1.03] −ΔHbO2/min, P < .05). Increased microvascular oxygen consumption during pain crisis could affect the local oxygen saturation of hemoglobin when oxygen delivery is limiting. Identifying the mechanisms of elevated oxygen consumption during pain crisis might lead to the development of new therapeutic interventions. This trial was registered at www.clinicaltrials.gov as #NCT01568710. •Patients with sickle cell disease have greater microvascular oxygen consumption rates than healthy individuals.•During sickle cell pain crisis, microvascular oxygen consumption increases further.