The impact of sickle cell disease on exercise capacity in children

Rifat A ChaudrySuzanne Crowley


Little is known about pulmonary vascular complications in children with sickle cell disease (SCD). We hypothesized that transfer factor (diffusing capacity of the lung for carbon monoxide [D(LCO)] ) may be used as a surrogate for the size of the pulmonary vascular bed and that pulmonary vascular abnormalities in children with SCD may limit exercise capacity. Fifty stable patients with SCD aged 10 to 18 years and 50 healthy control subjects matched for race and age were recruited. Incremental ergometer cardiopulmonary exercise testing was performed using respiratory mass spectrometry for exhaled gas analysis. A rebreathing maneuver was used to measure functional residual capacity, effective pulmonary blood fl ow (Qpeff), and D(LCO), and helium dilution was used to calculate minute ventilation, oxygen consumption, and CO 2 production. In the 89 evaluable subjects, there were no ventilatory differences between SCD and control subjects. Qpeff was consistently 15% to 20% greater in subjects with SCD than control subjects at all stages, but D(LCO) corrected for both surface area and hemoglobin was only about 7% to 10% greater in subjects with SCD at all stages. As a result, the D(LCO)/Qpeff ratio was considerably lower in SCD at all ...Continue Reading


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Related Concepts

Anemia, Sickle Cell
Carbon Dioxide
Cardiopulmonary Exercise Test
Oxygen Consumption
Pulmonary Diffusing Capacity
Regional Blood Flow
Nested Case-Control Studies

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