Transcranial doppler ultrasonography (TCD) in infants with sickle cell anemia: baseline data from the BABY HUG trial
Steven G Pavlakis, Renée C Rees, Xiangke Huang, R Clark Brown, James F Casella, Rathi V Iyer, Ram Kalpatthi, Judy Luden, Scott T Miller, Zora R Rogers, Courtney D Thornburg, Winfred C Wang, Robert J Adams, BABY HUG Investigators, Steven G Pavlakis, Renée C Rees, Xiangke Huang, R Clark Brown, James F Casella, Rathi V Iyer, Ram Kalpatthi, Judy Luden, Scott T Miller, Zora R Rogers, Courtney D Thornburg, Winfred C Wang, Robert J Adams, BABY HUG Investigators
Abstract
Background: Transcranial Doppler ultrasonography (TCD) is used to predict stroke risk in children with sickle cell anemia (SCA), but has not been adequately studied in children under age 2 years.
Procedure: TCD was performed on infants with SCA enrolled in the BABY HUG trial. Subjects were 7-17 months of age (mean 12.6 months). TCD examinations were successfully performed in 94% of subjects (n = 192).
Results: No patient had an abnormal TCD as defined in the older child (time averaged maximum mean TAMM velocity > or =200 cm/sec) and only four subjects (2%) had velocities in the conditional range (170-199 cm/sec). TCD velocities were inversely related to hemoglobin (Hb) concentration and directly related to increasing age.
Conclusion: Determination of whether the TCD values in this very young cohort of infants with SCA can be used to predict stroke risk later in childhood will require analysis of exit TCD's and long-term follow-up, which is ongoing (ClinicalTrials.gov number, NCT00006400).
(c) 2009 Wiley-Liss, Inc.
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Source: PubMed