Inhaled nitric oxide for acute chest syndrome in people with sickle cell disease

Sickle cell disease is an inherited blood disorder affecting approximately 250 million people worldwide. Sickle-shaped red blood cells which are characteristic of sickle cell disease may block blood vessels causing pain, tissue death and even severe damage in the major organs. Similar blockages in the blood vessels of the lungs can lead to lung injury and a complication known as acute chest syndrome which occurs in approximately 30% of people with sickle cell disease. Common symptoms include fever, coughing, chest pain and shortness of breath; some of which can be life-threatening. Treatment is mainly supportive and given when an individual experiences symptoms and may include antibiotics, drugs to help prevent the clotting of blood and other conventional treatments. Interest has been shown recently in inhaling nitric oxide, a soluble gas. This gas is known to play a role in expanding blood vessels and clumping platelets, to relieve some of the symptoms of acute chest syndrome. It is also used for treatment in similar conditions, namely pulmonary hypertension (high blood pressure in the blood vessels of the lungs) in babies up to four weeks old. The authors of the review did not find any trials showing how effective inhaled nitric oxide is for acute chest syndrome in people with sickle cell disease. The authors concluded that future research should provide evidence for people to make informed decisions about whether nitric oxide is effective.