Research output: Contribution to journal › Article › Academic › peer-review
Fluid overload due to intravenous fluid therapy for vaso-occlusive crisis in sickle cell disease: incidence and risk factors. / Gaartman, Aafke E.; Sayedi, Ajab K.; Gerritsma, Jorn J. et al.
In: British journal of haematology, Vol. 194, No. 5, 01.09.2021, p. 899-907.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Fluid overload due to intravenous fluid therapy for vaso-occlusive crisis in sickle cell disease: incidence and risk factors
AU - Gaartman, Aafke E.
AU - Sayedi, Ajab K.
AU - Gerritsma, Jorn J.
AU - de Back, Tim R.
AU - van Tuijn, Charlotte F.
AU - Tang, Man Wai
AU - Heijboer, Harriët
AU - de Heer, Koen
AU - Biemond, Bart J.
AU - Nur, Erfan
N1 - Funding Information: E.J. van Beers: Van Creveldkliniek, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; B.J. Biemond: Department of Hematology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; M. Beijlevelt: Department of Pediatric Hematology, Emma Children?s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands; P.P.T. Brons: Department of Pediatric Hematology, Amalia Children's Hospital, Radboudumc, University Medical Center, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, the Netherlands; M.H. Cnossen: Department of Pediatric Hematology, Erasmus University Medical Center?Sophia Children's Hospital, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; K. Fijnvandraat: Department of Pediatric Hematology, Emma Children?s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands; Sanquin Research, Department of Molecular Cellular Hemostasis, Sanquin Research, PO Box?9190, 1006 AD Amsterdam, the Netherlands; H. Heijboer: Department of Pediatric Hematology, Emma Children?s Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands; F. Hofstede: Department of Hematology, Haga Hospital, Els Borst-Eilersplein 275, 2545 AA Den Haag, the Netherlands; J.L.H. Kerkhoffs: Department of Hematology, Haga Hospital, Els Borst-Eilersplein 275, 2545 AA Den Haag, the Netherlands; E. Nur: Department of Hematology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; C. Ootjers: Department of Hematology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; P.J. de Pagter: Department of Pediatric Hematology, Erasmus University Medical Center ? Sophia Children's Hospital,?Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; Department of Pediatric Hematology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; A.W. Rijneveld: Department of Hematology, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; S.E.M. Schols: Department of Hematology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherland; F.J. Smiers: Department of Pediatric Hematology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; M.H. Suiker: Van Creveldkliniek, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; C.F.J. van Tuijn: Department of Hematology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; I. van Vliet: Department of Pediatric Hematology, Erasmus University Medical Center, Sophia Children's Hospital, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; E. Zwagemaker: Van Creveldkliniek, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Publisher Copyright: © 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Intravenous fluid therapy (IV-FT) is routinely used in the treatment of vaso-occlusive crises (VOCs), as dehydration possibly promotes and sustains erythrocyte sickling. Patients with sickle cell disease (SCD) are at risk of developing diastolic dysfunction and fluid overload due to IV-FT. However, data on the adverse effects of IV-FT for VOC is sparse. We aimed to evaluate the incidence and risk factors of fluid overload due to IV-FT in patients with SCD. Consecutive hospitalisations for VOC treated with IV-FT between September 2016 and September 2018 were retrospectively analysed. The median (interquartile range) age was 25·0 (18·3–33·8) years and 65% had a severe genotype (HbSS/HbSβ0-thal). Fluid overload occurred in 21% of 100 patients. Hospital stay was longer in patients with fluid overload (6·0 vs. 4·0 days, P = 0·037). A positive history of fluid overload (P = 0·017), lactate dehydrogenase level (P = 0·011), and top-up transfusion during admission (P = 0·005) were independently associated with fluid overload occurrence. IV-FT was not reduced in 86% of patients despite a previous history of fluid overload. Fluid overload is frequently encountered during IV-FT for VOC. IV-FT is often not adjusted despite a positive history of fluid overload or when top-up transfusion is indicated, emphasising the need for more awareness of this complication and a personalised approach.
AB - Intravenous fluid therapy (IV-FT) is routinely used in the treatment of vaso-occlusive crises (VOCs), as dehydration possibly promotes and sustains erythrocyte sickling. Patients with sickle cell disease (SCD) are at risk of developing diastolic dysfunction and fluid overload due to IV-FT. However, data on the adverse effects of IV-FT for VOC is sparse. We aimed to evaluate the incidence and risk factors of fluid overload due to IV-FT in patients with SCD. Consecutive hospitalisations for VOC treated with IV-FT between September 2016 and September 2018 were retrospectively analysed. The median (interquartile range) age was 25·0 (18·3–33·8) years and 65% had a severe genotype (HbSS/HbSβ0-thal). Fluid overload occurred in 21% of 100 patients. Hospital stay was longer in patients with fluid overload (6·0 vs. 4·0 days, P = 0·037). A positive history of fluid overload (P = 0·017), lactate dehydrogenase level (P = 0·011), and top-up transfusion during admission (P = 0·005) were independently associated with fluid overload occurrence. IV-FT was not reduced in 86% of patients despite a previous history of fluid overload. Fluid overload is frequently encountered during IV-FT for VOC. IV-FT is often not adjusted despite a positive history of fluid overload or when top-up transfusion is indicated, emphasising the need for more awareness of this complication and a personalised approach.
KW - fluid overload
KW - fluid therapy
KW - pulmonary oedema
KW - sickle cell disease
KW - vaso-occlusive crisis
UR - http://www.scopus.com/inward/record.url?scp=85110181694&partnerID=8YFLogxK
U2 - 10.1111/bjh.17696
DO - 10.1111/bjh.17696
M3 - Article
C2 - 34263922
VL - 194
SP - 899
EP - 907
JO - British journal of haematology
JF - British journal of haematology
SN - 0007-1048
IS - 5
ER -
ID: 19613539