FLUOSOL IN THE TREATMENT OF SICKLE-CELL CRISIS

The enhancement of oxygen delivery to ischemic tissue has long been a goal of sickle cell treatment. Fluosol, a member of the family of comp ounds known as perfluorocarbons, solubilizes large volumes of oxygen w hich should be beneficial in vaso-occlusive crises. A clinical trial u sing Fluosol in the management of sickle cell crisis was undertaken in seven patients, three men and four women, aged 18-37 y, with homozygo us S-S disease. Patients were randomized within 12 h of hospital admis sion to standard supportive care, with or without Fluosol, 20 mL/kg, g iven intravenously over 4-10 h. Presenting symptoms in most patients w ere leg and back pain. A crossover design allowed both methods of trea tment to be tested in each patient. Parameters evaluated included subj ective pain intensity, rapidity of pain relief, cumulative narcotic us e; and duration of crisis. At 48 h, pain intensity and narcotic use we re not measurably different between Fluosol-treated crises and those t reated with standard supportive care. Acute toxicity, in the form of h ypertension and vomiting, prompted the withdrawal of one patient, and two others experienced hematuria and worsening of back pain, respectiv ely, following Fluosol administration. In summary, this study was not able to demonstrate that Fluosol improved treatment. Variables includi ng the timing of drug administration, dose, and stage of crisis may ne ed to toe assessed in a larger trial before concluding that Fluosol ha s no role in sickle cell disease. Copyright (C) 1996 Elsevier Science Ltd.