RT Journal Article
SR Electronic
T1 Improving the safety of right heart catheterisation in sickle cell disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2314
VO 44
IS Suppl 58
A1 Jenny Louise Bacon
A1 Praveen Kumar Molanguri
A1 Adam Loveridge
A1 Francois J. Raphael
A1 Brendan Madden
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2314.abstract
AB Background:Pulmonary hypertension(PH) is a recognised complication in patients with sickle cell disease(SCD) with a prevalence of 6-10%.1 The gold standard to diagnose PH is right heart catheterisation(RHC), but SCD patients are at increased risk of developing complications including vasoocclusive crises. Our centre performs >160 RHC annually and developed a protocol in conjunction with our haematologists to attempt to reduce the risk of SCD complication during RHC. This involves pre hydration, supplemental oxygenation and passive warming.Methods:Electronic records were retrospectively reviewed to identify all patients with SCD who underwent RHC over 4years. Procedure indication, method and complications were recorded, haemodynamic variables and echocardiography results reviewed.Results:11 procedures were performed with pre hydration, passive warming and perioperative supplemental oxygen given in all cases. Mean mPAP was 21mmHg(range 15-39mmHg). 3 patients had PH but normal pulmonary vascular resistance. There was 1 episode of abdominal pain post procedure but no episodes of vasoocclusive crisis or other complication.Echocardiography diagnosis was 66% sensitive, 60% specific.Discussion:No specific protocol regarding optimisation for RHC in SCD has previously been reported. This study demonstrates that RHC can be performed in SCD without complication. By taking simple measures physicians can attempt to minimise the risk of vasoocclusive crisis. Measurement of pulmonary haemodynamics by RHC should be encouraged when clinically indicated in SCD to obtain accurate pulmonary haemodynamic values and formulate appropriate management strategies.(1)Parent F et al. NEJM 2011.