PMID: 9536918Apr 16, 1998Paper

Peripheral vascular response to mild indirect cooling in patients with homozygous sickle cell (SS) disease and the frequency of painful crisis

Clinical Science
J S MohanG R Serjeant

Abstract

1. In homozygous sickle cell (SS) disease, skin cooling is a common precipitating factor of the painful crisis which is associated with avascular necrosis of active bone marrow. Since skin cooling does not directly induce sickling, we have investigated the nature of the reflex vascular responses to mild cooling in SS patients in a steady state of the disease and compared them with their history of painful crises. 2. Experiments were performed in Jamaica on 60 male SS patients and 30 matched control subjects with normal haemoglobin (AA) genotype. Forearm blood flow (FBF) was measured by venous occlusion plethysmography and mean arterial pressure (MAP) by a Finapres device: forearm vascular resistance (FVR) was calculated as MAP/FBF. Cutaneous erythrocyte flux in forearm and hand was monitored by a laser Doppler meter. The contralateral hand was immersed in cool water at 16 degrees C for 2 min, 6 times, at random intervals of 0.5-3 min. 3. The first cool immersion evoked an increase in MAP, cutaneous vasoconstriction and a net increase in FVR in both AA and SS subjects. However, the direction of change in FVR varied between individuals such that 18 AA subjects showed an increase in FVR (constrictor group) while 12 showed a decrea...Continue Reading

Citations

May 27, 2014·Blood Cells, Molecules & Diseases·Patricia Ann ShiVijay Nandi
Jun 5, 2012·Experimental Physiology·Veline S L'EsperanceGeraldine F Clough
Jun 26, 2010·The Journal of Emergency Medicine·Alexander L RogovikRan D Goldman
Aug 2, 2008·Pediatric Pulmonology·Robert C StrunkMichael R DeBaun
Jun 24, 2014·Pain·Katherine J ZappiaCheryl L Stucky
Apr 20, 2017·The New England Journal of Medicine·Frédéric B PielDavid C Rees
Aug 25, 2006·American Journal of Hematology·Sadia Saleem, Lawrence Rice
Apr 9, 1998·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·J S MohanG R Serjeant
Dec 30, 2014·Medicine·Armand Mekontso DessapSandrine Katsahian
Jan 9, 2001·Journal of Neurosurgical Anesthesiology·P G Firth, R A Peterfreund
Jun 28, 2012·Physiological Measurement·Tiziano BinzoniJean-Noël Hyacinthe
Dec 17, 2010·European Journal of Clinical Investigation·Junette S MohanJanice M Marshall

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