Fluosol in the treatment of sickle cell crisis

Abstract

The enhancement of oxygen delivery to ischemic tissue has long been a goal of sickle cell treatment. Fluosol, a member of the family of compounds known as perfluorocarbons, solubilizes large volumes of oxygen which should be beneficial in vaso-occlusive crises. A clinical trial using Fluosol in the management of sickle cell crisis was undertaken in seven patients, three men and four women, aged 18–37 y, with homozygous S-S disease. Patients were randomized within 12 h of hospital admission to standard supportive care, with or without Fluosol, 20 mL/kg, given intravenously over 4–10 h. Presenting symptoms in most patients were leg and back pain. A crossover design allowed both methods of treatment to be tested in each patient. Parameters evaluated included subjective pain intensity, rapidity of pain relief, cumulative narcotic use, and duration of crisis. At 48 h, pain intensity and narcotic use were not measurably different between Fluosoltreated crises and those treated with standard supportive care. Acute toxicity, in the form of hypertension and vomiting, prompted the withdrawal of one patient, and two others experienced hematuria and worsening of back pain, respectively, following Fluosol administration. In summary, this study was not able to demonstrate that Fluosol improved treatment. Variables including the timing of drug administration, dose, and stage of crisis may need to be assessed in a larger trial before concluding that Fluosol has no role in sickle cell disease.