Sequential Measurement of Nitric Oxide Levels During Acute Vasoocclusive Sickle Cell Crisis in the ED

2.50
Hdl Handle:
http://hdl.handle.net/10755/162781
Type:
Presentation
Title:
Sequential Measurement of Nitric Oxide Levels During Acute Vasoocclusive Sickle Cell Crisis in the ED
Abstract:
Sequential Measurement of Nitric Oxide Levels During Acute Vasoocclusive Sickle Cell Crisis in the ED
Conference Sponsor:Emergency Nurses Association
Conference Year:1998
Author:Davis-Moon, Linda, RN, MSN, CEN
P.I. Institution Name:Thomas Jefferson University, Emergency Department
Contact Address:, Philadelphia, PA, USA
Co-Authors:Bernard Lopez, MD, FACEP and Samir Belas, MD
Purpose: Nitric oxide is a vasodilator that plays a significant role in the regulation of tissue blood perfusion. Prior study demonstrated that higher pretreatment nitric oxide levels are associated with lower overall pain scores in acute vasoocclusive sickle cell crisis (SCC). This study measured sequential nitric oxide levels during the ED course of treatment of SCC.

Design/Setting: A prospective, randomized clinical trial was conducted at an urban university teaching hospital ed with 52,000 visits per year.

Sample: A convenience sample of patients age equal to or greater than 18 years with a typical SCC was studied. Excluded were those with atypical pain or acute, coexistent disease (presence of fever, tachycardia, tachypnea, hypotension, or objective evidence of infection).

Methodology: Blood nitric oxide levels were obtained at 2-hour intervals during the ED treatment of pain and were measured using a nitric oxide-specific chemiluminescence technique. Pain was measured in 2-hour intervals using a 10 cm visual analog scale (VAS). Subjects were divided into: group 1 - persistent paid during ED treatment (overall change VAS equal to or less than 13 mm); and group 2 - improved pain ( overall change VAS> 13 mm).

Results: Sixty-one SCC patients were studied. There was no significant correlation between change in pain score and change in nitric oxide levels at either the two-hour intervals or during the overall treatment period. Nitric oxide upon ED admission was significantly lower in group 1 (n=28, 11.49 micrometers +/- 6.1, p<0.05 vs. 22.19 micrometers +/- 1.6, control group (n=20) of steady-state, non-SCC sickle cell anemia) than in group 2 (n=33, 17.9 micrometers +/- 7.6).

Conclusions: Sickle cell crisis patients with persistent pain had significantly lower initial nitric oxide levels. This particular subset of SCC patients may present with a higher degree of vasoconstriction and may be refractory to analgesic therapy. Nitric oxide levels may predict the course of pain improvement during nitric oxide therapy. [Research Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSequential Measurement of Nitric Oxide Levels During Acute Vasoocclusive Sickle Cell Crisis in the EDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162781-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Sequential Measurement of Nitric Oxide Levels During Acute Vasoocclusive Sickle Cell Crisis in the ED</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1998</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Davis-Moon, Linda, RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Thomas Jefferson University, Emergency Department</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Philadelphia, PA, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Bernard Lopez, MD, FACEP and Samir Belas, MD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Nitric oxide is a vasodilator that plays a significant role in the regulation of tissue blood perfusion. Prior study demonstrated that higher pretreatment nitric oxide levels are associated with lower overall pain scores in acute vasoocclusive sickle cell crisis (SCC). This study measured sequential nitric oxide levels during the ED course of treatment of SCC.<br/><br/>Design/Setting: A prospective, randomized clinical trial was conducted at an urban university teaching hospital ed with 52,000 visits per year.<br/><br/>Sample: A convenience sample of patients age equal to or greater than 18 years with a typical SCC was studied. Excluded were those with atypical pain or acute, coexistent disease (presence of fever, tachycardia, tachypnea, hypotension, or objective evidence of infection).<br/><br/>Methodology: Blood nitric oxide levels were obtained at 2-hour intervals during the ED treatment of pain and were measured using a nitric oxide-specific chemiluminescence technique. Pain was measured in 2-hour intervals using a 10 cm visual analog scale (VAS). Subjects were divided into: group 1 - persistent paid during ED treatment (overall change VAS equal to or less than 13 mm); and group 2 - improved pain ( overall change VAS&gt; 13 mm).<br/><br/>Results: Sixty-one SCC patients were studied. There was no significant correlation between change in pain score and change in nitric oxide levels at either the two-hour intervals or during the overall treatment period. Nitric oxide upon ED admission was significantly lower in group 1 (n=28, 11.49 micrometers +/- 6.1, p&lt;0.05 vs. 22.19 micrometers +/- 1.6, control group (n=20) of steady-state, non-SCC sickle cell anemia) than in group 2 (n=33, 17.9 micrometers +/- 7.6).<br/><br/>Conclusions: Sickle cell crisis patients with persistent pain had significantly lower initial nitric oxide levels. This particular subset of SCC patients may present with a higher degree of vasoconstriction and may be refractory to analgesic therapy. Nitric oxide levels may predict the course of pain improvement during nitric oxide therapy. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:34:02Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:34:02Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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