Zeitschrift für Hämatologie und thromboembolische Erkrankungen
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Effect of Nitric Oxide Inhalation in Acute Pain Crisis of Sickle Cell Disease: A Preliminary Report

Dipika Mohanty, Banambar Ray and Shakti Sankar Pattanayak

Background and objectives: The Vaso-occlusive Crisis (VOC) is a very common manifestation of Sickle Cell Disease patients in India which is characterised by severe body, chest and joint pain. The patho-physiology of VOC is due to abnormal nitric oxide dependent regulation of vascular tone, adhesion of sickle cells (deoxygenated) to endothelium, platelet activation and inflammation. Therefore, nitric oxide inhalation may relieve such condition and also pain. Method: Twenty patients of SCD (Sickle Cell Disease) aged 10 years and above with acute pain admitted to Emergency Department of Apollo Hospitals, Bhubaneswar were given ‘NO’ inhalation for 6 hrs at 80 ppm. Pain was measured by Visual Analog Scale (VAS) initially and at hourly interval for 6 hrs. Results: Out of 20 cases of SCD, 18 patients responded to ‘NO’ inhalation and there was significant reduction in pain score compared to initial values. NO alteration in vital parameters like B.P., Pulse, Respiration seen and no rise in Methemoglobin level occurred during therapy. Interpretation and Conclusion: The Nitric oxide inhalation therapy in sickle cell VOC cases is effective and also safe. It controls the acute pain significantly. However, since it is a small study, multicentric trial in large number of patients is suggested.