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Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Incentive spirometry to prevent acute pulmonary complications in sickle cell diseases
P S Bellet1, K A Kalinyak, R Shukla
1Division of General Pediatrics, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
The New England Journal of Medicine
|September 14, 1995
Summary
Thoracic bone infarction is common in sickle cell disease patients hospitalized with chest pain. Incentive spirometry significantly reduced pulmonary complications like atelectasis and infiltrates in these patients.
Area of Science:
- Hematology
- Pulmonology
- Pediatrics
Background:
- Sickle cell disease (SCD) patients often experience acute chest or back pain above the diaphragm.
- Thoracic bone infarction is a potential complication during SCD hospitalizations.
- Pulmonary complications such as atelectasis and infiltrates are concerns in SCD patients.
Purpose of the Study:
- To determine the incidence of thoracic bone infarction in hospitalized SCD patients.
- To test if incentive spirometry reduces atelectasis and pulmonary infiltrates in SCD patients.
Main Methods:
- Prospective, randomized trial involving 29 SCD patients (ages 8-21) with 38 pain episodes.
- Patients were randomized to incentive spirometry or a control group.
- Pulmonary complications and thoracic bone infarction were assessed via radiography and bone scanning.
Main Results:
- Thoracic bone infarction occurred in 39.5% of hospitalizations (15/38).
- Pulmonary complications were significantly lower in the spirometry group (1/19) vs. the control group (8/19; P=0.019).
- In patients with thoracic bone infarction, spirometry prevented pulmonary complications (0/7) compared to controls (5/8; P=0.025).
Conclusions:
- Thoracic bone infarction is a frequent complication in SCD patients hospitalized with acute chest pain.
- Incentive spirometry effectively prevents pulmonary complications associated with acute chest syndrome in hospitalized SCD patients.
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