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Long-term oxygen therapy in children with sickle cell disease and hypoxaemia
  1. Ilaria Liguoro1,2,
  2. Michele Arigliani3,4,
  3. Bethany Singh2,4,
  4. David Rees5,
  5. Baba P D Inusa2,
  6. Atul Gupta4,6
  1. 1Department of Medicine, DAME—Division of Paediatrics, Universita degli Studi di Udine, Udine, Italy
  2. 2Paediatric Haematology, Evelina London Children’s Hospital, London, UK
  3. 3Pediatric Respiratory Medicine and Lung Transplantation, Great Ormond Street Hospital for Children, London, UK
  4. 4Paediatric Respiratory Medicine, King’s College Hospital NHS Foundation Trust, London, UK
  5. 5Department of Paediatric Haematology, King’s College London, London, UK
  6. 6Department of Women and Children's Health, School of Life Course Sciences, Kings College London, London, United Kingdom
  1. Correspondence to Dr Atul Gupta, Department of Paediatric Respiratory Medicine, King's College London, London, UK; atul.gupta{at}kcl.ac.uk

Abstract

Objective To evaluate the acceptability and safety profile of nocturnal long-term oxygen therapy (LTOT) in children with sickle cell disease (SCD) and chronic hypoxaemia.

Design Retrospective cohort study.

Patients, setting and intervention Children with SCD who started LTOT from 2014 to early 2019 in two tertiary hospitals in London, UK were retrospectively enrolled. Patients who started disease-modifying therapies <12 months before LTOT or while on LTOT were excluded.

Main outcome measures Minor and major adverse events during LTOT were reported. Laboratory and clinical data, transcranial Doppler (TCD) scans and overnight oximetry studies performed at steady state within 12 months before and after starting LTOT were compared.

Results Nineteen children (10 males; median age 12 years, range 6–15) were included. Nearly half of them (9/19; 47%) were on hydroxyurea at baseline. No child discontinued LTOT because of intolerance or poor adherence. No major adverse events were reported. Laboratory data did not show significant changes in haemoglobin and reticulocyte count after 1 year of follow-up. No statistically significant change in the incidence of vaso-occlusive pain events was noted (median annual rate from 0.5 to 0 episode per patient/year; p=0.062). Overnight oximetry tests performed while on LTOT showed improvements in all oxygen saturation parameters (mean overnight and nadir SpO2, % of time spent with SpO2 <90%) compared with the baseline.

Conclusion LTOT is a safe and feasible treatment option for children with SCD and chronic hypoxaemia.

  • pain
  • patient reported outcome measures
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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests BPDI received educational grants from Novartis Plc, AstraZeneca, Cyclerion and Bluebird bio.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplementary information. Deidentified participant data may be available on reasonable request from IL.

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