Bronchodilator response was not significantly associated with acute chest syndrome (P=0.86) or its recurrences (P=0.63) in children and adolescents with sickle cell disease.
Observational (n=53)
No
Is bronchodilator response associated with acute chest syndrome and its recurrences in children with sickle cell disease?
In children with sickle cell disease, bronchodilator response on pulmonary function testing is not significantly associated with the occurrence or recurrence of acute chest syndrome.
p-value: p=0.72
Abstract BACKGROUND Sickle cell anemia is a globally prevalent hematological disorder. Acute chest syndrome (ACS), asthma, pulmonary hypertension and venous thromboembolism are examples of pulmonary complications in sickle cell disease. While several studies have explored the relationship between asthma, airway hyperresponsiveness, and acute chest syndrome, no study has yet demonstrated the association between bronchodilator response (BDR) and ACS. Methods This study explored the relationship between BDR and ACS, and their recurrences in children and adolescents with sickle cell disease (SCD). This retrospective chart review included patients from Arkansas Children’s Hospital from 2017 to July 2025, during which we assessed BDR using pulmonary function tests (PFTs). We calculated both ERS/ATS 2022 criteria (positive if change 10% in FEV1), and Pre 2021 ERS/ATS criteria (positive if ≥ 12% and ≥200ml increase in FEV1 after SABA use) for each patient. We analyzed the association between BDR and ACS using the Chi-square test, and identified factors contributing to ACS using univariate and multivariate logistic regression, with statistical significance at P 0.05. Results Between January 2017 and July 2025, 53 patients with SCD underwent PFTs and BDR assessments. The median age was 14 years, with 56.6% male and 43.4% female. ACS was observed in 71.7% of patients, while 84.9% experienced a SCC. For BDR, the P-values using the pre-2021 ERS/ATS criteria were 0.72 for ACS and 0.40 for recurrent ACS, while the 2022 criteria yielded P-values of 0.86 and 0.63, respectively. Patients with negative BDR had ACS recurrence rates of 38% (pre-2021) and 40% (2022), with a P-value of 0.632. The P-values for BMI percentile were 0.21 and 0.03 (adjusted for age, asthma, allergy, and White Cell Count) for ACS. For history of prior chest syndrome, the P-values were 0.04 and 0.05 (adjusted similarly) for ACS. Conclusion Our study did not find a significant association between BDR and ACS and recurrences. We observed that ACS recurrence is lower in patients with a negative BDR than in those with a positive BDR, though this finding was non-significant statistically. BMI and H/O prior ACS were significant predictors of ACS. The findings are limited by the sample size, the retrospective study design, and the fact that PFT and BDR are conducted only in sickle cell patients after episodes of ACS or other respiratory issues. This highlights the need for a follow-up study with a prospective design and a larger sample size to strengthen the validity of the research findings. This abstract is funded by: NA
Jawaid et al. (Fri,) conducted a observational in Sickle cell disease (n=53). Bronchodilator response (BDR) assessment vs. Negative BDR vs Positive BDR was evaluated on Acute chest syndrome (ACS) and recurrent ACS (p=0.72). Bronchodilator response was not significantly associated with acute chest syndrome (P=0.86) or its recurrences (P=0.63) in children and adolescents with sickle cell disease.