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Study Highlights Potential Benefits of Lactated Ringer’s for Sickle Cell Treatment
Sickle cell disease is a prevalent genetic condition marked by recurrent painful episodes caused by vaso-occlusive events, where sickle-shaped blood cells obstruct blood flow in the vessels. The intensity of these episodes can vary significantly, from mild discomfort to debilitating pain that necessitates hospital treatment.
Recent research conducted by experts from Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center’s (BMC) Center of Excellence in Sickle Cell Disease, and the Evans Center for Implementation and Improvement Science has revealed promising findings regarding the treatment of sickle cell disease patients. The study indicates that patients treated with Lactated Ringer’s solution, an intravenous fluid designed to restore hydration and electrolyte balance in individuals with low blood volume or pressure, experienced shorter hospital stays, reduced readmission rates, and less reliance on intravenous opioids compared to those receiving normal saline.
“Currently, the standard care for patients suffering vaso-occlusive pain episodes from sickle cell disease typically involves normal saline, as indicated by existing clinical guidelines. However, our findings challenge these norms and suggest a reconsideration of current practices,” stated Dr. Nicholas Bosch, the study’s lead author and assistant professor at the Boston University medical school.
The research team analyzed a comprehensive database containing information from over 1,000 hospitals across the U.S. They targeted patients diagnosed with sickle cell disease who were admitted with vaso-occlusive crises. By utilizing machine learning models, the researchers were able to accurately compare clinical outcomes of those treated with Lactated Ringer’s to those treated with normal saline.
The results revealed that patients administered Lactated Ringer’s enjoyed significantly more days free of hospital visits and experienced both a decreased duration of hospital stays and a lower risk of readmission within 30 days compared to normal saline recipients.
“Sickle cell patients often require extensive medical services and frequently return for additional care,” said Bosch. “Transitioning from normal saline to Lactated Ringer’s could enhance patient outcomes while also potentially reducing overall healthcare expenses.”
While randomized controlled trials are the traditional method for comparing treatment modalities, Bosch noted that such trials in sickle cell disease would demand an implausibly large participant base, a threshold that has never been met in previous studies. Instead, the research team employed large observational datasets alongside sophisticated machine learning techniques to achieve results comparable to those of a traditional trial. “Our findings underscore the urgent need for a shift in standard treatment protocols,” Bosch added.
These significant results are available online in JAMA Internal Medicine.
The study received funding from various institutions, including the National Institute of Health (NIH) National Center for Advancing Translational Sciences (NCATS) as well as the American Heart Association Career Development Award and the Boston University Chobanian & Avedisian School of Medicine Department of Medicine Career Investment Award.
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