Long-term oxygen therapy viable in kids with sickle cell disease, chronic hypoxaemia

Low-flow nocturnal long-term oxygen therapy (LTOT) appears to be a safe and viable treatment option in children with sickle cell disease and chronic hypoxaemia, a study has shown.

Researchers reviewed the medical records of 19 paediatric patients (median age, 12 years; 10 boys) treated with LTOT, none of whom had received disease-modifying therapies <12 months before or while on LTOT.

Nine of the patients were on hydroxyurea at baseline, and 11 had a previous history of asthma. LTOT was administered at a median 0.5 L/min of supplemental oxygen. There were no reports of treatment discontinuation, except for a patient who stopped therapy after 10 months due to marked improvements in overnight oximetry.

Four children had minor adverse effects related to the use of LTOT. They complained of nasal prong discomfort or nasal dryness at some point over the follow-up period. Other than these, there were no major adverse event observed.

Laboratory data showed no meaningful changes in haemoglobin and reticulocyte count after 1 year of follow-up. Likewise, there was no significant change seen in the incidence of vaso-occlusive pain events (median annual rate from 0.5 to 0 episode per patient/year; p=0.062).

On the other hand, results of overnight oximetry tests performed while on LTOT indicated marked improvements in all oxygen saturation parameters (mean overnight and nadir SpO2, % of time spent with SpO2 <90 percent) compared with the baseline.

Beneficial effects of LTOT should be confirmed in larger prospective studies with longer follow-up, according to the researchers. These studies are needed to identify the subgroups of patients with sickle cell disease and chronic hypoxaemia who are most likely to benefit from LTOT according to baseline characteristics and duration/modalities of intervention.