Pain crisis in children with sickle cell disease (SCD) is typically managed with intravenous\nfluids and parenteral opioids in the pediatric emergency department. Electrical cardiometry (EC)\ncan be utilized to measure cardiac output (CO) and cardiac index (CI) non-invasively. Near-infrared\nspectroscopy (NIRS) measuring cerebral (rCO2) and splanchnic regional (rSO2) mixed venous\noxygenation non-invasively has been utilized for monitoring children with SCD. We studied the\nvalue and correlation of NIRS and EC in monitoring hemodynamic status in children with SCD\nduring pain crisis. We monitored EC and NIRS continuously for 2 h after presentation and during\nmanagement. Forty-five children participated in the study. CO (D = 1.72), CI (D = 1.31), rSO2\n(D = 11.6), and rCO2 (D = 9.3), all increased over time. CO max and CI max were achieved 1 h after\nstarting resuscitation. rCO2 max attainment was quicker than rSO2, as monitored by NIRS. CI max\ncorrelated with rCO2 max (r = âË?â??0.350) and rSO2 max (r = âË?â??0.359). In adjustment models, initial CI\nsignificantly impacted initial rCO2 (p = 0.045) and rCO2 max (p = 0.043), while initial CO impacted\nrCO2 max (p = 0.030). Cardiac output monitoring and NIRS monitoring for cerebral and splanchnic\noxygenation were feasible and improved the monitoring of therapeutic interventions for children\nwith SCD during pain crisis.
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