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Peripheral vascular response to inspiratory breath hold in paediatric homozygous sickle cell disease

Peripheral vascular response to inspiratory breath hold in paediatric homozygous sickle cell disease
Peripheral vascular response to inspiratory breath hold in paediatric homozygous sickle cell disease
There is increasing evidence that autonomic dysfunction in adults with homozygous sickle cell (haemoglobin SS) disease is associated with enhanced autonomic nervous system-mediated control of microvascular perfusion. However, it is unclear whether such differences are detectable in children with SS disease. We studied 65 children with SS disease [38 boys; median age 7.2 (interquartile range 5.1–10.6) years] and 20 control children without symptoms of SS disease [8 boys; 8.7 (5.5–10.8) years] and recorded mean arterial blood pressure (ABP) and daytime haemoglobin oxygen saturation (). Cutaneous blood flux at rest (RBF) and during the sympathetically activated vasoconstrictor response to inspiratory breath hold (IBH) were measured in the finger pulp of the non-dominant hand using laser Doppler fluximetry. Local factors mediating flow motion were assessed by power spectral density analysis of the oscillatory components of the laser Doppler signal. The RBF measured across the two study groups was negatively associated with age (r = ?0.25, P < 0.0001), ABP (r = ?0.27, P = 0.02) and daytime (r = ?0.30, P = 0.005). Children with SS disease had a higher RBF (P = 0.005) and enhanced vasoconstrictor response to IBH (P = 0.002) compared with control children. In children with SS disease, higher RBF was associated with an increase in the sympathetic interval (r = ?0.28, P = 0.022). The SS disease status, daytime and age explained 22% of the variance in vasoconstrictor response to IBH (P < 0.0001). Our findings suggest that blood flow and blood flow responses in the skin of young African children with SS disease differ from those of healthy control children, with increased resting peripheral blood flow and increased sympathetic stimulation from a young age in SS disease. They further suggest that the laser Doppler flowmetry technique with inspiratory breath hold manoeuvre appears to be robust for use in young children with SS disease, to explore interactions between , ABP and autonomic function with clinical complications, e.g. skin ulceration.
0958-0670
49-56
L'Esperance, Veline S.
a722ddeb-9d6b-4f3e-9597-c9faf5104a67
Cox, Sharon E.
40718807-416d-47df-a663-18df62802590
Simpson, David M.
53674880-f381-4cc9-8505-6a97eeac3c2a
Gill, Carolyn Anne
33a26d0c-2da6-4823-a356-30a8d9fe35a0
Makani, Julie
76a145a7-02fc-43ea-a1df-3a52d2004e48
Soka, Deogratias
493329a2-35e6-4fce-9402-bcfe516ab775
Mgaya, Josephine
740b5114-40dc-4020-bbe0-c54475f34328
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Clough, Geraldine F.
9f19639e-a929-4976-ac35-259f9011c494
L'Esperance, Veline S.
a722ddeb-9d6b-4f3e-9597-c9faf5104a67
Cox, Sharon E.
40718807-416d-47df-a663-18df62802590
Simpson, David M.
53674880-f381-4cc9-8505-6a97eeac3c2a
Gill, Carolyn Anne
33a26d0c-2da6-4823-a356-30a8d9fe35a0
Makani, Julie
76a145a7-02fc-43ea-a1df-3a52d2004e48
Soka, Deogratias
493329a2-35e6-4fce-9402-bcfe516ab775
Mgaya, Josephine
740b5114-40dc-4020-bbe0-c54475f34328
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Clough, Geraldine F.
9f19639e-a929-4976-ac35-259f9011c494

L'Esperance, Veline S., Cox, Sharon E., Simpson, David M., Gill, Carolyn Anne, Makani, Julie, Soka, Deogratias, Mgaya, Josephine, Kirkham, Fenella J. and Clough, Geraldine F. (2013) Peripheral vascular response to inspiratory breath hold in paediatric homozygous sickle cell disease. Experimental Physiology, 98 (1), 49-56. (doi:10.1113/expphysiol.2011.064055).

Record type: Article

Abstract

There is increasing evidence that autonomic dysfunction in adults with homozygous sickle cell (haemoglobin SS) disease is associated with enhanced autonomic nervous system-mediated control of microvascular perfusion. However, it is unclear whether such differences are detectable in children with SS disease. We studied 65 children with SS disease [38 boys; median age 7.2 (interquartile range 5.1–10.6) years] and 20 control children without symptoms of SS disease [8 boys; 8.7 (5.5–10.8) years] and recorded mean arterial blood pressure (ABP) and daytime haemoglobin oxygen saturation (). Cutaneous blood flux at rest (RBF) and during the sympathetically activated vasoconstrictor response to inspiratory breath hold (IBH) were measured in the finger pulp of the non-dominant hand using laser Doppler fluximetry. Local factors mediating flow motion were assessed by power spectral density analysis of the oscillatory components of the laser Doppler signal. The RBF measured across the two study groups was negatively associated with age (r = ?0.25, P < 0.0001), ABP (r = ?0.27, P = 0.02) and daytime (r = ?0.30, P = 0.005). Children with SS disease had a higher RBF (P = 0.005) and enhanced vasoconstrictor response to IBH (P = 0.002) compared with control children. In children with SS disease, higher RBF was associated with an increase in the sympathetic interval (r = ?0.28, P = 0.022). The SS disease status, daytime and age explained 22% of the variance in vasoconstrictor response to IBH (P < 0.0001). Our findings suggest that blood flow and blood flow responses in the skin of young African children with SS disease differ from those of healthy control children, with increased resting peripheral blood flow and increased sympathetic stimulation from a young age in SS disease. They further suggest that the laser Doppler flowmetry technique with inspiratory breath hold manoeuvre appears to be robust for use in young children with SS disease, to explore interactions between , ABP and autonomic function with clinical complications, e.g. skin ulceration.

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More information

e-pub ahead of print date: 1 June 2012
Published date: 1 January 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 350904
URI: http://eprints.soton.ac.uk/id/eprint/350904
ISSN: 0958-0670
PURE UUID: 962c7389-6bdb-4e0b-868e-f727c8a2fb16
ORCID for David M. Simpson: ORCID iD orcid.org/0000-0001-9072-5088
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958
ORCID for Geraldine F. Clough: ORCID iD orcid.org/0000-0002-6226-8964

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Date deposited: 10 Apr 2013 13:42
Last modified: 09 Jan 2022 03:10

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Contributors

Author: Veline S. L'Esperance
Author: Sharon E. Cox
Author: Carolyn Anne Gill
Author: Julie Makani
Author: Deogratias Soka
Author: Josephine Mgaya

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