Philip Crispin
Haematology,Canberra Hospital,WODEN,Australia;John Curtin School of Medical Research,Australian National University,Acton,Australia
EHA Library. Crispin P. Jun 15, 2019; 267209; PS1592
Philip Crispin
Philip Crispin

Abstract: PS1592

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Transfusion of red cells in chronic hypoproliferative anemia aims to improve function in the recipients. Few studies examine functional measures as a trigger for transfusion, in part due to limited tools to functionally assess anemia.

To evaluate the effect of anemia on muscle oxygen saturation (SmO2) during exercise.

Haematology patients with and without anaemia and normal controls were invited to participate. Each undertook a six minute walk test (6MWT) with continuous gastrocnemius SmO2 monitoring. Patients with a significant change in haemoglobin (such as due to transfusion) were invited to repeat the investigation, up to three subsequent times. Changes in SmO2 were examined in the pooled results of controls, key parameters identified and then extracted from individual participants. The correlation of each parameter with 6WWT distance, as a measure of functional capacity, was evaluated by linear and multifactorial regression. Participants with repeated 6MWT before and after hemoglobin changes were compared with paired T tests.

There were 73 participants, including 28 with known or presumed normal haemoglobin levels, undertaking 93 walking tests. Examination of control participant curves identified the SmO2 parameters at baseline, nadir and plateau levels, with the fall in SmO2 defined as the difference between baseline and nadir SmO2. In univariate analysis the distance walked correlated with haemoglobin (r=0.47, p<0.001), baseline SmO2, (r=0.34, p=0.001), nadir SmO2 (r=0.26, p=0.013) and the plateau SmO2(r=0.4, p=0.001) however these were not independent cofactors in multivariate analysis. The fall in SmO2 did not correlate with the distance walked. There were 17 paired sets of walks with changed hemoglobin levels. An improved 6MWT distance was observed with increased hemoglobin concentration (p<0.01), but there was no significant improvement in SmO2 values in individuals with higher haemoglobin concentrations.

Anemia is associated with reduced function as measured by 6MWT distance and reduced SmO2 before and during exercise.  The absolute fall in SmO2 during submaximal exercise was not increased by anemia. This may be due to decreased rate of oxygen demand with shorter walk distances seen in anemia. Although SmO2 values are associated with the functional impairment of anemia, they are not superior to currently used triggers.

Session topic: 31. Transfusion medicine

Keyword(s): Anemia

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