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Trends in complete blood count values during acute painful episodes in children with sickle cell disease
Eufemia Jacob1, Christine Miaskowski, Marilyn Savedra
1Pediatric Oncology, Baylor College of Medicine, Texas Children's Cancer Center and Hematology Service, 6701 Fannin, suite 1400, MC 3-3320, Houston, TX 77030, USA. exjacob@texaschildrenshospital.org
Insights
Complete blood count (CBC) values indicate sickle cell disease (SCD) complications. While CBC trends mirrored early healing during painful episodes, moderate pain persisted despite resolving hemolytic and inflammatory markers.
Area of Science:
- Pediatrics
- Hematology
- Pain Management
Background:
- Complete blood count (CBC) values are used to assess hemolytic and inflammatory processes in children with sickle cell disease (SCD) during acute painful episodes.
- Understanding the relationship between CBC trends and pain intensity is crucial for managing vaso-occlusive crises.
Purpose of the Study:
- To examine trends in CBC values during hospitalization for vaso-occlusive episodes in children with SCD.
- To determine the relationship between CBC values and patient-reported pain intensity scores.
Main Methods:
- Prospective study involving hospitalized children (5-19 years) with SCD admitted for vaso-occlusive pain.
- Daily CBC values were collected from the hospital information system.
- Patient pain intensity was assessed nightly using the African American Oucher pain scale.
Main Results:
- Parallel changes in CBC values and pain intensity scores were observed within the first 48 hours of hospitalization.
- Despite resolution of hemolytic and inflammatory processes indicated by CBC trends, moderate pain persisted throughout the hospitalization period.
Conclusions:
- CBC values show parallel trends with pain intensity in the initial phase of vaso-occlusive crises in children with SCD.
- Persistent moderate pain despite resolving inflammatory and hemolytic markers suggests a complex pain experience in SCD that requires further investigation beyond CBC monitoring.
Abstract:
Complete blood count (CBC) values are monitored as crude indicators of the hemolytic and inflammatory processes that accompany an acute painful episode in children with sickle cell disease. As part of a larger study that examined the pain experience and pain management of hospitalized children during painful vaso-occlusive episodes, the authors examined trends in CBC values and determined whether there were relationships between these values and pain intensity scores. Children, 5 to 19 years of age, with sickle cell disease whose primary reason for admission was vasoocclusive pain were recruited for participation in the study. Once every evening from the day of admission until the day of discharge, they were asked to rate their worst and least pain using the numeric rating scale of the African American Oucher pain scale. Complete blood count values were obtained from the hospital information system on a daily basis. Parallel changes in CBC values and pain intensity scores were evident within the first 48 hours of hospitalization. However, although the inflammatory and hemolytic processes were resolving, pain persisted at moderate levels throughout the course of hospitalization.
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