Auto-adjusting positive airway pressure in children with sickle cell anemia: results of a phase I randomized controlled trial
Marshall, Melanie J., Bucks, Romola S., Hogan, Alexandra M., Hambleton, Ian R., Height, Susan E., Dick, Moira C., Kirkham, Fenella J. and Rees, David C. (2009) Auto-adjusting positive airway pressure in children with sickle cell anemia: results of a phase I randomized controlled trial. Haematologica, 94, (7), 1006-1010. (doi:10.3324/haematol.2008.005215).
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Low nocturnal oxygen saturation (SpO2) is implicated in complications of Sickle Cell Anemia (SCA). Twenty-four children with SCA were randomized to receive overnight auto-adjusting continuous positive airway pressure (auto-CPAP) with supplemental oxygen, if required, to maintain SpO2 94% or as controls. We assessed adherence, safety, sleep parameters, cognition and pain. Twelve participants randomized to auto-CPAP (3 with oxygen) showed improvement in Apnea/Hypopnea Index (p<0.001), average desaturation events >3%/hour (p=0.02), mean nocturnal SpO2 (p=0.02) and cognition. Primary efficacy endpoint (Processing Speed Index) showed no group differences (p=0.67), but a second measure of processing speed and attention (Cancellation) improved in those receiving treatment (p=0.01). No bone marrow suppression, rebound pain or serious adverse event resulting from auto-CPAP use was observed. Six weeks of auto-CPAP therapy is feasible and safe in children with SCA, significantly improving sleep-related breathing disorders and at least one aspect of cognition.
|Keywords:||therapy, red cells, hemoglobinopathies, quality of life, continuous positive airway pressure, oxygen saturation|
|Divisions:||University Structure - Pre August 2011 > School of Medicine > Clinical Neurosciences
|Date Deposited:||11 Dec 2009|
|Last Modified:||01 Jun 2011 15:17|
|Contributors:||Marshall, Melanie J. (Author)
Bucks, Romola S. (Author)
Hogan, Alexandra M. (Author)
Hambleton, Ian R. (Author)
Height, Susan E. (Author)
Dick, Moira C. (Author)
Kirkham, Fenella J. (Author)
Rees, David C. (Author)
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