Hypoxaemia in children with sickle cell anaemia in Khartoum state

Abstract

Sickle cell disease is often complicated acutely or chronically by hypoxaemia. This is a descriptive cross-sectional hospital based study aimed to determine the frequency and possible associated factors of hypoxemia in patients with sickle cell anaemia in their steady state and crises. It was conducted in the sickle cell anaemia referral clinic in KCEH and paediatric wards in most of Khartoum state hospitals in the period from the 1st of April to the 30th of June 2004. The total number of children enrolled in the study was 149 children with sickle cell anaemia aged 0 - ≤16 yrs, 100 of them in their steady state while 49 were in crises and 80(53.7%) were males while 69(46.3%) were females . Oxygen saturation (SpO2) was measured for all children by pulse oximeter and haematological investigations were also done. The overall frequency of hypoxaemia (SpO2 ≤ 90%) was found to be 37.6% and the mean SpO2 was 92.3% ± 6.0. The frequency of hypoxaemia in patients with steady state was 39% while in those with crises was 34.6% and there was no significant difference between the two groups (p = 0.373). There was no significant correlation between hypoxaemia and gender of patient but hypoxaemia was found to be more frequent in older age groups (p = 0.001) and in those with low weight centile (p= 0.028) but not with height (p = 0.864). Hypoxaemia was found to be associated with history of recurrent chest infection (p = 0.009) but not with history of blood transfusion or recurrent painful episodes. In patients with crises hypoxaemia was found to be correlated with breathlessness as a presenting symptoms (p =0.002) and there was a significant correlation with the type of crises (p = 0.031). Hypoxaemia was found to be correlated with low Hb (p = 0.000), low PCV (p = 0.005) and HbF (p = 0.001) but there was no correlation with retics count (p = 0.310)