Morphine Is Associated With Acute Chest Syndrome in Children Hospitalized With Sickle Cell Disease

[摘要] Objective: To determine if intravenous morphine is associated with acute chest syndrome (ACS) in children with homozygous for hemoglobin S sickle cell disease (SCD) hospitalized with acute pain.Methods: Health records of patients with homozygous for hemoglobin S SCD aged 2 to 18 years hospitalized with acute pain were reviewed. Patients developed ACS at least 12 hours after emergency department triage; controls did not develop ACS. Survival analyses were performed.Results: There were 38 cases and 45 randomly selected controls. The mean hourly dose of morphine 1, 2, and 3 hours before ACS and cumulative mean morphine dose up to 5 hours before ACS were significantly associated with ACS ( P < .05). Adjusted analysis showed that 1 hour before ACS, the mean morphine dose was significantly higher in cases (40 µg/kg) compared with controls (34 µg/kg), and the risk of ACS increased by 23% for each additional 10 µg/kg of morphine received ( P = .02).Conclusions: We recommend close observation for ACS in hospitalized patients with SCD who are receiving morphine.* Abbreviations: ACS : acute chest syndrome CI : confidence interval ED : emergency department HR : hazard ratio HbSS : homozygous for hemoglobin S IV : intravenous PCA : patient-controlled analgesia PMIU : pediatric medicine inpatient unit SCD : sickle cell disease

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob