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Morphine is associated with acute chest syndrome in children hospitalized with sickle cell disease

Catherine S Birken1, Amina Khambalia, Annie Dupuis

  • 1Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. catherine.birken@sickkids.ca

Hospital Pediatrics
|December 18, 2013
PubMed

Insights

Children with sickle cell disease (SCD) receiving morphine for pain may have an increased risk of acute chest syndrome (ACS). Close monitoring for ACS is recommended during hospitalization for SCD patients on morphine.

Area of Science:

  • Pediatric Hematology
  • Pain Management
  • Sickle Cell Disease Research

Background:

  • Sickle cell disease (SCD) is a genetic blood disorder.
  • Acute chest syndrome (ACS) is a common and serious complication of SCD.
  • Pain management is crucial for hospitalized SCD patients.

Purpose of the Study:

  • To investigate the association between intravenous morphine use and the development of acute chest syndrome (ACS).
  • To assess the risk of ACS in children with homozygous hemoglobin S SCD receiving morphine for acute pain.

Main Methods:

  • Retrospective review of health records for SCD patients aged 2-18 years hospitalized with acute pain.
  • Comparison of morphine dosage in patients who developed ACS (cases) versus those who did not (controls).
  • Survival analysis to determine the association between morphine dose and ACS incidence.

Main Results:

  • Morphine dosage in the hours preceding ACS was significantly associated with its development.
  • Patients who developed ACS received a higher mean morphine dose (40 microg/kg) compared to controls (34 microg/kg) one hour before ACS.
  • Each additional 10 microg/kg of morphine increased the risk of ACS by 23%.

Conclusions:

  • Intravenous morphine administration is associated with an increased risk of ACS in children with SCD.
  • Close observation for ACS symptoms is recommended for hospitalized SCD patients receiving morphine.
  • Further research may explore optimal pain management strategies to mitigate ACS risk.
Abstract

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