Breathing patterns during vaso-occlusive crisis of sickle cell disease

Joshua P. Needleman, Lennette J. Benjamin, Joseph A. Sykes, Thomas K. Aldrich

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Study objectives: To determine the effect of sickle cell pain and its treatment on patients' breathing patterns, and to compare the effect of thoracic cage pain to pain at other sites. Design: Prospective, observational study. Setting: Sickle Cell Center Day Hospital. Patients: Twenty-five patients with sickle cell disease admitted to the Sickle Cell Center Day Hospital for treatment of vaso-occlusive crisis (VOC) [10 patients with chest (thoracic cage) pain]. Interventions: Breathing patterns were measured by respiratory inductive plethysmography. Tidal breathing data, including respiratory rate, tidal volume (VT), minute ventilation, and the rib cage contribution to VT, were collected at baseline and then following treatment with opioid analgesia. Measurements and results: The patients with chest pain had smaller VTs at baseline than those with pain at other sites (355 ± 37 mL vs 508 ± 141 mL, p = 0.003), and higher respiratory rates (23.2 ± 8.2 breaths/min vs 17.6 breaths/min, p = 0.03). These differences became insignificant following opioid treatment. Six patients had respiratory alternans (four patients in the chest pain group, and two patients with pain at other sites). All cases of respiratory alternans resolved following opioid administration. Conclusions: Patients with VOC and chest pain have more shallow, rapid breathing than patients with pain elsewhere. Analgesia reduces these differences. As pain-associated shallow breathing and maldistribution of ventilation may contribute to the pathogenesis of acute chest syndrome, these results support the need for adequate pain relief and monitoring of ventilatory patterns during the treatment of VOC.

Original languageEnglish (US)
Pages (from-to)43-46
Number of pages4
JournalChest
Volume122
Issue number1
DOIs
StatePublished - 2002

Fingerprint

Sickle Cell Anemia
Respiration
Chest Pain
Pain
Opioid Analgesics
Respiratory Rate
Analgesia
Ventilation
Acute Chest Syndrome
Therapeutics
Plethysmography
Tidal Volume
Observational Studies
Thorax
Prospective Studies

Keywords

  • Acute chest syndrome
  • Respiratory alternans
  • Respiratory inductive plethysmography
  • Sickle cell disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Needleman, J. P., Benjamin, L. J., Sykes, J. A., & Aldrich, T. K. (2002). Breathing patterns during vaso-occlusive crisis of sickle cell disease. Chest, 122(1), 43-46. https://doi.org/10.1378/chest.122.1.43

Breathing patterns during vaso-occlusive crisis of sickle cell disease. / Needleman, Joshua P.; Benjamin, Lennette J.; Sykes, Joseph A.; Aldrich, Thomas K.

In: Chest, Vol. 122, No. 1, 2002, p. 43-46.

Research output: Contribution to journalArticle

Needleman, JP, Benjamin, LJ, Sykes, JA & Aldrich, TK 2002, 'Breathing patterns during vaso-occlusive crisis of sickle cell disease', Chest, vol. 122, no. 1, pp. 43-46. https://doi.org/10.1378/chest.122.1.43
Needleman, Joshua P. ; Benjamin, Lennette J. ; Sykes, Joseph A. ; Aldrich, Thomas K. / Breathing patterns during vaso-occlusive crisis of sickle cell disease. In: Chest. 2002 ; Vol. 122, No. 1. pp. 43-46.
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abstract = "Study objectives: To determine the effect of sickle cell pain and its treatment on patients' breathing patterns, and to compare the effect of thoracic cage pain to pain at other sites. Design: Prospective, observational study. Setting: Sickle Cell Center Day Hospital. Patients: Twenty-five patients with sickle cell disease admitted to the Sickle Cell Center Day Hospital for treatment of vaso-occlusive crisis (VOC) [10 patients with chest (thoracic cage) pain]. Interventions: Breathing patterns were measured by respiratory inductive plethysmography. Tidal breathing data, including respiratory rate, tidal volume (VT), minute ventilation, and the rib cage contribution to VT, were collected at baseline and then following treatment with opioid analgesia. Measurements and results: The patients with chest pain had smaller VTs at baseline than those with pain at other sites (355 ± 37 mL vs 508 ± 141 mL, p = 0.003), and higher respiratory rates (23.2 ± 8.2 breaths/min vs 17.6 breaths/min, p = 0.03). These differences became insignificant following opioid treatment. Six patients had respiratory alternans (four patients in the chest pain group, and two patients with pain at other sites). All cases of respiratory alternans resolved following opioid administration. Conclusions: Patients with VOC and chest pain have more shallow, rapid breathing than patients with pain elsewhere. Analgesia reduces these differences. As pain-associated shallow breathing and maldistribution of ventilation may contribute to the pathogenesis of acute chest syndrome, these results support the need for adequate pain relief and monitoring of ventilatory patterns during the treatment of VOC.",
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N2 - Study objectives: To determine the effect of sickle cell pain and its treatment on patients' breathing patterns, and to compare the effect of thoracic cage pain to pain at other sites. Design: Prospective, observational study. Setting: Sickle Cell Center Day Hospital. Patients: Twenty-five patients with sickle cell disease admitted to the Sickle Cell Center Day Hospital for treatment of vaso-occlusive crisis (VOC) [10 patients with chest (thoracic cage) pain]. Interventions: Breathing patterns were measured by respiratory inductive plethysmography. Tidal breathing data, including respiratory rate, tidal volume (VT), minute ventilation, and the rib cage contribution to VT, were collected at baseline and then following treatment with opioid analgesia. Measurements and results: The patients with chest pain had smaller VTs at baseline than those with pain at other sites (355 ± 37 mL vs 508 ± 141 mL, p = 0.003), and higher respiratory rates (23.2 ± 8.2 breaths/min vs 17.6 breaths/min, p = 0.03). These differences became insignificant following opioid treatment. Six patients had respiratory alternans (four patients in the chest pain group, and two patients with pain at other sites). All cases of respiratory alternans resolved following opioid administration. Conclusions: Patients with VOC and chest pain have more shallow, rapid breathing than patients with pain elsewhere. Analgesia reduces these differences. As pain-associated shallow breathing and maldistribution of ventilation may contribute to the pathogenesis of acute chest syndrome, these results support the need for adequate pain relief and monitoring of ventilatory patterns during the treatment of VOC.

AB - Study objectives: To determine the effect of sickle cell pain and its treatment on patients' breathing patterns, and to compare the effect of thoracic cage pain to pain at other sites. Design: Prospective, observational study. Setting: Sickle Cell Center Day Hospital. Patients: Twenty-five patients with sickle cell disease admitted to the Sickle Cell Center Day Hospital for treatment of vaso-occlusive crisis (VOC) [10 patients with chest (thoracic cage) pain]. Interventions: Breathing patterns were measured by respiratory inductive plethysmography. Tidal breathing data, including respiratory rate, tidal volume (VT), minute ventilation, and the rib cage contribution to VT, were collected at baseline and then following treatment with opioid analgesia. Measurements and results: The patients with chest pain had smaller VTs at baseline than those with pain at other sites (355 ± 37 mL vs 508 ± 141 mL, p = 0.003), and higher respiratory rates (23.2 ± 8.2 breaths/min vs 17.6 breaths/min, p = 0.03). These differences became insignificant following opioid treatment. Six patients had respiratory alternans (four patients in the chest pain group, and two patients with pain at other sites). All cases of respiratory alternans resolved following opioid administration. Conclusions: Patients with VOC and chest pain have more shallow, rapid breathing than patients with pain elsewhere. Analgesia reduces these differences. As pain-associated shallow breathing and maldistribution of ventilation may contribute to the pathogenesis of acute chest syndrome, these results support the need for adequate pain relief and monitoring of ventilatory patterns during the treatment of VOC.

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