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Trends in Complete Blood Count Values During Acute Painful Episodes in Children With Sickle Cell Disease

exjacob{at}texaschildrenshospital.org

Christine Miaskowski, PhD, RN, FAAN

Department of Physiological Nursing at the University of California San Francisco

Marilyn Savedra, PhD, RN, FAAN

Department of Family Health Care Nursing at the University of California San Francisco

Judith E. Beyer, PhD, RN

School of Nursing, University of Missouri Kansas City

Marsha Treadwell, PhD

Departments of Hematology and Psychiatry, Children’s Hospital and Research Center at Oakland, Oakland, CA

Lori Styles, MD

Departments of Hematology and Oncology, Children’s Hospital and Research Center at Oakland, Oakland, CA

Complete blood count (CBC) values are monitored as crude indicators of the hemolytic and inflammatory processes that accompany an acute painful episode in children with sickle cell disease. As part of a larger study that examined the pain experience and pain management of hospitalized children during painful vaso-occlusive episodes, the authors examined trends in CBC values and determined whether there were relationships between these values and pain intensity scores. Children, 5 to 19 years of age, with sickle cell disease whose primary reason for admission was vasoocclusive pain were recruited for participation in the study. Once every evening from the day of admission until the day of discharge, they were asked to rate their worst and least pain using the numeric rating scale of the African American Oucher pain scale. Complete blood count values were obtained from the hospital information system on a daily basis. Parallel changes in CBC values and pain intensity scores were evident within the first 48 hours of hospitalization. However, although the inflammatory and hemolytic processes were resolving, pain persisted at moderate levels throughout the course of hospitalization.

Key Words: acute painful episodes • CBC values • vasoocclusive pain • sickle cell disease

Journal of Pediatric Oncology Nursing, Vol. 22, No. 3, 152-159 (2005)
DOI: 10.1177/1043454204273734


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