Hematologic and hemorheological determinants of resting and exercise-induced hemoglobin oxygen desaturation in children with sickle cell disease

Xavier Waltz, Marc Romana, Marie Laure Lalanne-Mistrih, Roberto F. Machado, Yann Lamarre, Vanessa Tarer, Marie Dominique Hardy-Dessources, Benoît Tressières, Lydia Divialle-Doumdo, Marie Petras, Frederic Maillard, Maryse Etienne-Julan, Philippe Connes

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18 Scopus citations

Abstract

The aim of the study was to determine the factors associated with resting and exercise-induced hemoglobin oxygen desaturation. The well-established six-minute walk test was conducted in 107 sickle cell children (50 with sickle hemoglobin C disease and 57 with sickle cell anemia) at steady state. Hemoglobin oxygen saturation was measured before and immediately after the six-minute walk test. Blood samples were obtained on the same day to measure hematologic and hemorheological parameters. Exercise-induced hemoglobin oxygen desaturation was defined as a drop in hemoglobin oxygen saturation of 3% or more at the end of the six-minute walk test compared to resting levels. No children with sickle hemoglobin C disease, but approximately 50% of children with sickle cell anemia showed mild or moderate oxygen desaturation at rest, which was independently associated with the percentage of reticulocytes. Exercise-induced hemoglobin oxygen desaturation was observed in 18% of children with sickle hemoglobin C disease and 34% of children with sickle cell anemia, and was independently associated with the six-minute walk test, acute chest syndrome rate and the strength of red blood cell aggregates in children with sickle cell anemia. No association was found in children with sickle hemoglobin C disease between exerciseinduced hemoglobin oxygen desaturation and the measured parameters. Hemoglobin oxygen desaturation at rest was common in children with sickle cell anemia but not in children with sickle hemoglobin C disease, and was mainly associated with greater hemolysis. Physiological strain during exercise and red blood cell aggregation properties may predict the occurrence of exercise-induced hemoglobin oxygen desaturation in children with sickle cell anemia.

Original languageEnglish (US)
Pages (from-to)1039-1044
Number of pages6
JournalHaematologica
Volume98
Issue number7
DOIs
StatePublished - Jul 1 2013

ASJC Scopus subject areas

  • Hematology

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    Waltz, X., Romana, M., Lalanne-Mistrih, M. L., Machado, R. F., Lamarre, Y., Tarer, V., Hardy-Dessources, M. D., Tressières, B., Divialle-Doumdo, L., Petras, M., Maillard, F., Etienne-Julan, M., & Connes, P. (2013). Hematologic and hemorheological determinants of resting and exercise-induced hemoglobin oxygen desaturation in children with sickle cell disease. Haematologica, 98(7), 1039-1044. https://doi.org/10.3324/haematol.2013.083576