Lung function, transfusion, pulmonary capillary blood volume and sickle cell disease

Area of Science:

• Pulmonary Medicine
• Pediatric Hematology

Background:

• Children with sickle cell disease (SCD) often exhibit lung function abnormalities.
• Elevated pulmonary blood volume is a potential contributing factor to these abnormalities.

Purpose of the Study:

• To investigate the acute effects of blood transfusion on pulmonary capillary blood volume (PCBV) and respiratory system resistance (Rrs5) in children with SCD.
• To determine if changes in PCBV correlate with changes in Rrs5.

Main Methods:

• 18 children with SCD underwent spirometry and Rrs5 measurements before and after blood transfusion.
• Pulmonary capillary blood volume (PCBV) was calculated using diffusing capacity for carbon monoxide and nitric oxide.

Main Results:

• Following transfusion, Rrs5 increased significantly (p<0.0001), as did PCBV (p<0.0001).
• Forced expiratory volume in one second and vital capacity decreased (p=0.0056 and p=0.0008, respectively).
• Increased Rrs5 correlated with increased PCBV (r=0.50, p=0.0493).

Conclusions:

• Acute blood transfusion in children with SCD leads to increased pulmonary capillary blood volume.
• This increase in PCBV may contribute to the observed lung function abnormalities, including increased respiratory system resistance.