Knight-Madden, Jennifer M.; Hambleton, Ian R.
Author Affiliation, Ana.
Tropical Medicine Research Institute
Inhaled bronchodilators for acute chest syndrome in people with sickle cell disease
The Cochrane Database of Systematic Reviews
Date of Publication
Background: Bronchodilators are used to treat bronchial hyper-responsiveness in asthma. Bronchial hyper-responsiveness may be a component of acute chest syndrome in people with sickle cell disease. Therefore, bronchodilators may be useful in the treatment of acute chest syndrome. Objectives: To assess the benefits and risks associated with the use of bronchodilators in people with acute chest syndrome. Search strategy: Searches were carried out on the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, hand searches of relevant journals, abstracts, books and conference proceedings. Additional searches were carried out on MEDLINE (1966 to 2002) and EMBASE (1981 to 2002). The date of the most recent search of the Group's Haemoglobinopathies Trials Register: February 2005. Selection criteria: Randomised or quasi-randomised controlled trials. Trials using quasi-randomisation methods will be included in future updates of this review if there is sufficient evidence that the treatment and control groups are similar at baseline. Data collection and analysis: No trials investigating the use of bronchodilators for acute chest syndrome in people with sickle cell disease were found. Main results: We found no trials investigating the use of bronchodilators for acute chest syndrome in people with sickle cell disease. Authors' conclusions: If bronchial hyper-responsiveness is an important component of some episodes of acute chest syndrome in people with sickle cell disease, the use of inhaled bronchodilators may be indicated. There is need for a well-designed, adequately-powered randomised controlled trial to assess the benefits and risks of the addition of inhaled bronchodilators to established therapies for acute chest syndrome in people with sickle cell disease. Synopsis: Evidence is needed to determine whether bronchodilators (asthma drugs) can help people with sickle cell disease who have acute chest syndrome (ACS). Sickle cell disease (SCD) is an inherited blood disorder. People with SCD often experience acute chest syndrome (ACS), although it is not known why. ACS can cause fever, coughing, chest pain, shortness of breath and pain, and can be life-threatening. Often, people with SCD and ACS also wheeze, suggesting that breathing passages (airways) are narrowed, as with asthma. Bronchodilators (reliever inhalers) relax the muscles in the airways, opening the airways so breathing is easier. They are commonly used for asthma. However, no trials to show the effects of these inhaled bronchodilators for ACS in people with SCD were found.....