During vaso-occlusive crises in sickle cell patients, the efficacy of nitric oxide remains to be demonstrated

During vaso-occlusive crises in sickle cell patients, the efficacy of nitric oxide remains to be demonstrated

SOURCE

Aboursheid T, Albaroudi O, Alahdab F.

Inhaled nitric oxide for treating pain crises in people with sickle cell disease. CochraneDatabase of Systematic Reviews 2022, Issue 7. Art. No.: CD011808.

DOI: 10.1002/14651858.CD011808.pub3

CONTEXT

In sickle cell disease patients, vaso-occlusive crises can cause severe pain lasting from several hours to several days. The vasodilatory properties of inhaled nitric oxide (NO) could have a beneficial effect in this indication, but its actual efficacy remains debated.

CLINICAL QUESTION

What is the efficacy and what are the adverse effects of inhaled NO in the management of pain during vaso-occlusive crises in sickle cell patients?

BOTTOM LINE

Inhaled NO appears to have little or no effect on the duration of pain resolution and on pain recurrence (low level of evidence). There was no difference in the reduction of pain intensity during the first 8 hours. The use of inhaled NO was not associated with a reduction in the use of other analgesics. No serious adverse effects appear to be associated with the use of inhaled NO (low level of evidence).

CAVEATS

Only three small studies (188 patients in total) were included in this review. The results are inconclusive as to the effect of inhaled NO in treating pain in sickle cell patients with vaso-occlusive crises. Larger studies, with longer follow-up and more robust endpoints, should be carried out.

AUTHORS

Nordine Nekhili
nordine.nekhili@gmail.com
SMUR, F-95500 Gonesse, France
 
Mathieu Oberlin
mathieu.oberlin@outlook.fr
Centre hospitalier de Selestat, F-67600 Sélestat, France