Haemoglobin oxygen saturation, leucocyte count and lactate dehydrogenase are predictors of elevated cerebral blood flow velocity in Nigerian children with sickle cell anaemia
Date
2017
Authors
Ojewunmi, Oyesola Oyewole
Adeyemo, Titilope Adenike
Osuntoki, Akinniyi Adediran
Imaga, Ngozi Awa
Oyetunji, Ajoke Idayat
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor and Francis
Abstract
Background: Transcranial Doppler ultrasound (TCD) scan, which measures blood flow velocity
through the time-averaged mean of maximum velocities (TAMMVs) in the internal carotid
arteries and middle cerebral arteries, is a useful screening tool for predicting stroke risk in
children with sickle cell anaemia (SCA).
Aim: To investigate which clinical and laboratory indices predict abnormal TCD velocity in
children with SCA.
Methods: Fifty-four SCA patients with normal TCD (TAMMV < 170 cm/s), classified as negative
TCD (NTCD), and 93 patients with conditional and abnormal TCD velocities (TAMMV ≥ 170 cm/s)
classified as positive TCD were recruited. The haemoglobin oxygen saturation, haematological
variables, nitric oxide metabolites and lactate dehydrogenase activity of the patients were
analysed.
Results: The mean (SD) age was 7.16 (3.84) years (range 2–16). The median SpO2 of the patients
in the positive TCD group was significantly lower than that of the negative TCD group (p = 0.002).
Multivariate logistic regression analysis indicated that the MCV [odds ratio (OR) 1.12, 95%
confidence interval (CI) 1.04–1.22, p = 0.01)], MCH (OR 1.34, 95% CI 1.02–1.77, p = 0.04), leucocyte
count (OR 1.26, 95% CI 1.07–1.49, p = 0.01) and lactate dehydrogenase (LDH) level (OR 1.00, 95%
CI 1.00–1.01, p = 0.01) were independent predictors of high cerebral blood flow velocities.
Conclusions: These clinical and laboratory indices are characteristic of chronic hypoxia and
severe anaemia and are predictors of abnormal cerebral blood flow velocity. They can be used to
predict stroke risk in children with SCA when access to TCD screening is limited.
Description
Keywords
Research Subject Categories::NATURAL SCIENCES::Chemistry::Biochemistry , Transcranial Doppler , haemoglobin oxygen saturation , cerebral blood flow velocity , Sickle cell anaemia , stroke risk , lactate dehydrogenase , laboratory predictors , Nigeria
Citation
Oyesola Oyewole Ojewunmi, Titilope Adenike Adeyemo, Akinniyi Adediran Osuntoki, Ngozi Awa Imaga & Ajoke Idayat Oyetunji (2018) Paediatrics and International Child Health, 38:1:34-39.