Hyperbaric Oxygen Therapy in Sickle Cell Pain (HAVOC)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Sickle cell anemia is a genetic blood disorder where red blood cells are abnormally shaped, crescent- or sickle-shaped, instead of the normal, round shape. This misshapen cell is rigid and sticky, causing them to clump together and block small blood vessels. This blockage can lead to pain, infections, and organ damage, and the shortened lifespan of sickle cells causes anemia. Previous study suggest that hyperbaric oxygen (HBO) may help ameliorate symptoms and have positive effects for sickle cell patients. In addition, although a few studies did discuss pain reduction associated with HBO therapy, results are conflicting, and sample sizes are too small to carry any weight when compared against each other. No information has been gathered to date about how HBO therapy this may affect hospital length of stay. The purpose of this study is to determine if HBO treatment in participants experiencing sickle cell crisis would produce a decrease in pain and decrease in hospital length of stay.
Current standard of care at University of Nebraska Medical Center (UNMC) and Nebraska Medicine for patients identified as having sickle cell and experiencing an uncomplicated pain crisis that is not responding to acute treatment in the emergency department over the course of a few hours is to admit the patient to the hematology service. They would receive IV fluid administration, oxygen, and usually large doses of pain medications, until their pain subsides. Patient's complete blood count (CBC) and comprehensive metabolic panel (CMP) are monitored during this time for acute changes. Once pain has subsided and no signs of complications such as infection, etc. are found, the patient is discharged with follow up in hematology clinic.
Interventions would be 1-3 hyperbaric oxygen sessions depending on response to the therapy. Each treatment session will be approximately two hours in length. Evaluation would be through participants' self-assessment via the visual analog scale for pain level before and after treatments as well as tracking length of stay in the hospital. Changes in pain ratings will use the visual pain scale of 0 to 100, where 0 is no pain and 100 being maximal pain imaginable for that participant. Pain ratings will be compiled and compared 1 hour before and after each treatment and from daily pain ratings assessed at hospital admission until discharge. Hospital length of stay is recorded for each participant from date of randomization until date of discharge or date of death from any cause and compared to data extracted from the electronic health record system EPIC.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jeff S Cooper, MD
- Phone Number: 402-552-2490
- Email: jeffrey.cooper@unmc.edu
Study Locations
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Nebraska
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Omaha, Nebraska, United States, 68198
- Unversity of Nebraska Medical Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 19 years old or older
- Present with an uncomplicated sickle cell crisis at admission friom the emergency department
Exclusion Criteria:
- < 19 years old
- pregnant female
- complicated sickle cell crisis present (i.e., concomitant MI, stroke, acute chest syndrome at time of presentation)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: treatment
This preliminary study will be a convenience sample of patients admitted to hospital for vaso-occlusive sickle cell crisis to be treated with hyperbaric oxygen (HBO), the intervention, in an effort to ameliorate pain and shorten the length of hospital stay.
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Participants in vaso-occlusive crisis from sickle cell anemia will receive 1-3 hyperbaric oxygen (HBO) sessions depending on response to the therapy.
Each session will be approximately 2 hours in length at 2.5 ATM.
Minimum time between HBO sessions of 4 hours.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain Assessment per Treatment
Time Frame: one hour before and after each hyperbaric treatment
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Change in pain rating will be determined within one hour before and after each hyperbaric oxygen (HBO) treatment.
The pain scale is 0-100, 0 being no pain and 100 being maximal pain imaginable for that participant.
Pain assessments before and after each HBO treatment will be compiled and compared to determine treatment effectiveness.
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one hour before and after each hyperbaric treatment
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hospital Length of Stay
Time Frame: up to 1 month
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The hospital length of stay in days from date of randomization until date of discharge or date of death from any cause, whichever came first is recorded and compared to data extracted from the electronic health record system EPIC.
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up to 1 month
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Pain Assessment for All Treatments
Time Frame: up to 1 month (expected average of 3 days)
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Change in pain rating will be determined between enrollment and hospital discharge.
The scale is 0-100, 0 being no pain and 100 being maximal pain imaginable for that participant.
Pain assessments will occur at initial Emergency Department (ED) presentation and then every morning of admission until discharge.
Pain completely resolved or max session number of 3 will be used as standard to halt HBO therapies.
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up to 1 month (expected average of 3 days)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jeff S Cooper, MD, University of Nebraska
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Genetic Diseases, Inborn
- Hematologic Diseases
- Anemia, Hemolytic, Congenital
- Anemia, Hemolytic
- Anemia
- Hemoglobinopathies
- Anemia, Sickle Cell
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Hemic and Lymphatic Diseases
- Vaso-Occlusive Crises
- Therapeutics
- Respiratory Therapy
- Oxygen Inhalation Therapy
- Hyperbaric Oxygenation
Other Study ID Numbers
Other Study ID Numbers
- 0003-17-FB
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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