Inhaled bronchodilators for acute chest syndrome in people with sickle cell disease: Cochrane systematic review

Abstract

Assessed as up to date: 2016/09/20

Background

Bronchodilators are used to treat bronchial hyper-responsiveness in asthma. Bronchial hyper-responsiveness may be a component of acute chest syndrome in people with sickle cell disease. Therefore, bronchodilators may be useful in the treatment of acute chest syndrome. This is an update of a previously published Cochrane Review.

Objectives

To assess the benefits and risks associated with the use of bronchodilators in people with acute chest syndrome.

Search methods

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. Additional searches were carried out on MEDLINE (1966 to 2002) and Embase (1981 to 2002).

Date of the most recent search of the Group's Haemoglobinopathies Trials Register: 11 July 2016.

Selection criteria

Randomised or quasi-randomised controlled trials. Trials using quasi-randomisation methods will be included in future updates of this review if there is sufficient evidence that the treatment and control groups are similar at baseline.

Data collection and analysis

We found no trials investigating the use of bronchodilators for acute chest syndrome in people with sickle cell disease.

Main results

We found no trials investigating the use of bronchodilators for acute chest syndrome in people with sickle cell disease.

Authors' conclusions

If bronchial hyper-responsiveness is an important component of some episodes of acute chest syndrome in people with sickle cell disease, the use of inhaled bronchodilators may be indicated. There is need for a well-designed, adequately-powered randomised controlled trial to assess the benefits and risks of the addition of inhaled bronchodilators to established therapies for acute chest syndrome in people with sickle cell disease.

Author(s)

Knight-Madden Jennifer M, Hambleton Ian R

Summary

Inhaled drugs for opening up the airways in cases of acute chest syndrome in people with sickle cell disease

Review question

We reviewed the evidence about whether using inhaled, short-acting bronchodilators for acute chest syndrome reduces illness and mortality in people with sickle cell disease and to assess whether this treatment causes adverse effects. This is an update of a previously published Cochrane Review.

Background

Sickle cell disease is an inherited blood disorder. People with sickle cell disease often suffer from acute chest syndrome, although it is not known why. Acute chest syndrome can cause fever, coughing, chest pain and shortness of breath and can be life-threatening. Often, people with sickle cell disease and acute chest syndrome also wheeze. This suggests that airways are narrowed, as with asthma. Bronchodilators are drugs which relax the muscles in the airways, thus opening them up to make breathing easier. They are used in this way for asthma, so may be of similar use in acute chest syndrome.

Search date

The evidence is current to: 11 July 2016.

Study characteristics

We found no trials to show the effects of these drugs for this condition.

Key results

Research needs to assess the benefits and risks of using inhaled bronchodilators for acute chest syndrome in people with sickle cell disease.

Reviewer's Conclusions

Implications for practice

No randomised controlled trials on the use of inhaled bronchodilators in ACS were identified for inclusion in this review. The research evidence on which to base clinical decisions is therefore limited to case reports, and other less robust evidence.

Implications for research

There is need for a well-designed, adequately-powered randomised controlled trial to assess the benefits and risks of the addition of inhaled bronchodilators to established therapies for ACS in people with SCD.

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TY - ELEC T1 - Inhaled bronchodilators for acute chest syndrome in people with sickle cell disease: Cochrane systematic review ID - 433261 BT - Cochrane Abstracts UR - https://evidence.unboundmedicine.com/evidence/view/Cochrane/433261/all/Inhaled_bronchodilators_for_acute_chest_syndrome_in_people_with_sickle_cell_disease:_Cochrane_systematic_review DB - Evidence Central DP - Unbound Medicine ER -