Research

Sickle Cell Patients Who Receive Lactated Ringer’s Solution for Painful Episodes Experience Significant Improvements 

Sickle cell disease is a common genetic disorder characterized by periodic occurrences of pain—referred to as “vaso-occlusive episodes”—experienced repeatedly through life when sickled cells obstruct blood vessels. The degree of pain may range from a mild discomfort to a severe, disabling pain requiring treatment in a hospital. 

A study published in JAMA Internal Medicine by researchers at the Chobanian & Avedisian School of Medicine, Boston Medical Center’s Center of Excellence in Sickle Cell Disease, along with the Boston University Evans Center for Implementation and Improvement Science, found that hospital-admitted patients who received the fluid Lactated Ringer’s—a solution used rather than normal saline to replace water and electrolyte loss in patients with low blood volume or low blood pressure—had shorter hospital lengths of stay, lower 30-day readmission risk, and fewer days of intravenous opioid medications for pain control compared to those who received normal saline. 

“Currently, patients with sickle cell disease who are admitted to the hospital for vaso-occlusive pain episodes usually receive normal saline, and clinical decision support tools presently recommend normal saline. However, our results call these recommendations and current practice into question,” says corresponding author Nicholas Bosch MD, MSc, assistant professor of medicine. 

Researchers used a large database that included patient data from more than 1,000 US hospitals. They identified patients with sickle cell disease and vaso-occlusive pain episodes who were started on Lactated Ringer’s solution or normal saline on the first day of hospitalization, then used machine learning models to compare the rates of outcomes between the two.