Near Infrared Spectroscopy in Sickle Cell Pediatric Patients

Sponsor
Children's National Research Institute (Other)
Overall Status
Recruiting
CT.gov ID
NCT04031521
Collaborator
National Institute of Allergy and Infectious Diseases (NIAID) (NIH)
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Study Details

Study Description

Brief Summary

Endothelial dysfunction contributes to vaso-occlusion and acute pain in sickle cell disease. Near infrared spectroscopy (NIRS) technology can measure tissue oxygenation and endothelial function. The main objective of this study is to study the natural history of tissue muscle oxygenation using NIRS in pediatric sickle cell subjects experiencing acute pain and pediatric sickle cell patients in steady-state.

Condition or Disease Intervention/Treatment Phase
  • Diagnostic Test: Near infrared spectroscopy

Study Design

Study Type:
Observational
Anticipated Enrollment :
40 participants
Observational Model:
Case-Control
Time Perspective:
Prospective
Official Title:
Near-infrared Spectroscopy in Sickle Cell Pediatric Patients During Pain Crisis and After Recovery
Actual Study Start Date :
Jun 26, 2019
Anticipated Primary Completion Date :
Jun 30, 2022
Anticipated Study Completion Date :
Jun 30, 2022

Arms and Interventions

Arm Intervention/Treatment
Sickle cell pain crisis

Diagnostic Test: Near infrared spectroscopy
NIRS is an emerging technology for measuring tissue oxygenation and endothelial function. NIRS light can penetrate through biological tissues, including skin, bone, and muscle. Similar to other optical methods, light is applied to the region of interest and undergoes scattering and absorption before being detected by a photosensor. This technique is commonly used to assess oxygen availability and consumption in living tissues. Using different wavelengths, NIRS can differentiate between oxygenated and deoxygenated hemoglobin in blood and can measure changes in total hemoglobin concentration, using the sum of oxygenated and deoxygenated hemoglobin.

Sickle cell steady-state

Diagnostic Test: Near infrared spectroscopy
NIRS is an emerging technology for measuring tissue oxygenation and endothelial function. NIRS light can penetrate through biological tissues, including skin, bone, and muscle. Similar to other optical methods, light is applied to the region of interest and undergoes scattering and absorption before being detected by a photosensor. This technique is commonly used to assess oxygen availability and consumption in living tissues. Using different wavelengths, NIRS can differentiate between oxygenated and deoxygenated hemoglobin in blood and can measure changes in total hemoglobin concentration, using the sum of oxygenated and deoxygenated hemoglobin.

Outcome Measures

Primary Outcome Measures

  1. Tissue oxygenation [6 months]

Secondary Outcome Measures

  1. Nitric oxide [6 months]

Eligibility Criteria

Criteria

Ages Eligible for Study:
6 Years to 21 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria for Subjects with Sickle Cell Disease in Pain Crisis:
  1. Age 6 to 21 years old.

  2. Diagnosis of sickle cell anemia: a. Diagnosis of sickle cell disease (electrophoresis or HPLC documentation of hemoglobin SS, SC, S-beta-thalassemia or other hemoglobinopathies causing sickle cell disease is required).

  3. Acute onset pain crisis in a distribution typical for that subject, onset within the last 7 days and for which hospitalization and parenteral narcotic pain treatment are required.

  4. Ability to provide informed written consent.

Exclusion Criteria for Subjects with Sickle Cell Disease in Pain Crisis:
  1. Pregnancy.

  2. History of non-trivial injury, burns, surgery or skin ulcers on the arms.

  3. Fever or suspected sepsis at time of pain crisis

  4. Administration of any of the following drugs within the last 14 days:

  • Phosphodiesterase-5 inhibitors (sildenafil, vardenafil, tadalafil)

  • Endothelin-1 receptor blockers (bosentan, sitaxentan, ambrisentan, tezosentan)

  • Nitric oxide donors (nitroglycerin, nitroprusside, nitrates)

  1. Ingestion of caffeine within the 12 hours before the start of the study appointment, or tobacco use within the 30 days before the study appointment.

  2. Diagnosis with any of the following chronic diseases or conditions:

  • History of high blood pressure

  • History of high cholesterol

  • History of diabetes

  • History of chronic kidney disease (serum creatinine must not be greater than 2 mg/dL)

  • History of coronary artery disease or peripheral vascular disease

  1. Received a blood transfusion within 7 days of the study procedure.
Inclusion Criteria for Subjects with Sickle Cell Disease in Steady State:
  1. Age 6-21 years

  2. Diagnosis of sickle cell disease (electrophoresis or HPLC documentation of hemoglobin SS, SC, S-beta-thalassemia or other hemoglobinopathies causing sickle cell disease is required).

  3. Ability to provide informed written consent.

Exclusion Criteria for Subjects with Sickle Cell Disease in Steady State:
  1. Pregnancy.

  2. History of non-trivial trauma, burns, surgery or skin ulcers on the arms.

  3. Fever or suspected sepsis at time of pain crisis

  4. Experience of an acute pain crisis requiring intravenous (IV) narcotics and hospital admission within the last 14 days.

  5. Ingestion of caffeine within the 12 hours before the start of the study appointment, or tobacco use within the 30 days before the study appointment.

  6. Administration of any of the following drugs within the last 14 days:

  • Phosphodiesterase-5 inhibitors (sildenafil, vardenafil, tadalafil)

  • Endothelin-1 receptor blockers (bosentan, sitaxentan, ambrisentan, tezosentan)

  • Nitric oxide donors (nitroglycerin, nitroprusside, nitrates)

  1. Diagnosis of any of the following chronic diseases or conditions:
  • History of high blood pressure

  • History of high cholesterol

  • History of diabetes

  • History of chronic kidney disease (serum creatinine must not be greater than 2 mg/dL)

  • History of coronary artery disease or peripheral vascular disease

  1. Received a blood transfusion within 7 days of the study procedure.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Children's National Medical Center Washington District of Columbia United States 20010

Sponsors and Collaborators

  • Children's National Research Institute
  • National Institute of Allergy and Infectious Diseases (NIAID)

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Suvankar Majumdar, Chief of Hematology, Children's National Research Institute
ClinicalTrials.gov Identifier:
NCT04031521
Other Study ID Numbers:
  • Pro00012424
First Posted:
Jul 24, 2019
Last Update Posted:
Apr 1, 2022
Last Verified:
Mar 1, 2022
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
Yes
Product Manufactured in and Exported from the U.S.:
No
Additional relevant MeSH terms:

Study Results

No Results Posted as of Apr 1, 2022