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Medical student develops novel method to potentially correlate blood flow and pain in those with sickle cell disease

Catherine Doss

7 Mar 2024

Woman wearing white doctor's coat standing in a hallway — Ilona Kitay used a novel blood flow sensor to determine if pain could be anticipated and better managed in people with sickle cell disease. Photo by Ryan Anderson for Virginia Tech.

Sickle cell disease (SCD) is a group of genetic blood disorders that affects the shape of oxygen-carrying red blood cells. People with the disease can experience debilitating pain brought on by impaired blood flow. Often, patients in severe sickle cell disease pain go to the emergency room seeking relief, but without a means of determining pain levels, providers may not give strong enough medications or any medications at all.

“This can really lead to distrust between the hospital community and these patients,” said Ilona Kitay, a fourth-year student at the Virginia Tech Carilion School of Medicine, who has researched a novel sensor that may be able to correlate blood flow and pain. “If we catch these acute pain crises early on, we can treat them more effectively.”

Kitay’s research project earned her a Letter of Distinction at the school’s 2024 Student Research Symposium.

Project overview

“Our overarching goal was to determine if pain can be anticipated and better managed in SCD patients,” Kitay said. “We wanted to find out if there is an associated increase in pain when blood flow decreases. This could be a biomarker that doctors can use to determine if a patient with sickle cell is in pain.”

Before answering that question, she first needed to see if and how blood flow was different in patients with sickle cell disease. To aid in this, Kitay used the ThermaSENSE AccuFlow sensor, a new device developed by Ali Roghanizad, a Virginia Tech graduate, that can detect blood flow.

Kitay used a blood pressure cuff to briefly cut off blood flow, then released the cuff and used the sensor to determine blood flow ranges.

“The primary hypothesis was that SCD adults, as compared to healthy adults, will have higher baseline perfusion [blood flow], a longer time to return to baseline, and a longer time to reach maximum perfusion after the maneuver was performed.”

Findings

The first part of the research was a feasibility study using the blood pressure cuff-sensor maneuver on healthy adults to determine if the sensor could pick up differences in blood flow.

In the present and ongoing part of the study, Kitay recruited adults with and without sickle cell disease. So far, results showed modest — but not statistically significant differences — in blood flow, likely due to incomplete recruitment.

“Further studies should be done to assess the sensor’s capability to correlate changes in perfusion with pain in sickle cell disease.”

While she hasn’t met the recruitment targets yet, Kitay is optimistic further research will continue after she graduates in May.

“The project is definitely going somewhere,” she said. “Research can be a long, hard process. I’ve had to be flexible and willing to go back to the drawing board.”

Significance of research

Kitay learned about sickle cell disease as a medical student but until this research project, did not fully grasp the pain levels patients experience along with the barriers to getting treatment for the pain.

“Ilona’s project was important for continuing to find advancements in the world of sickle cell disease,” said Violet Borowicz, associate professor of pediatrics who was Kitay’s research mentor. “The idea of being able to predict a sickle cell crisis would allow patients a greater ability to get ahead of a debilitating experience with pain crises and allow for greater functioning long term.”

“A lot of these patients don’t just have isolated pain crises, but also live with chronic pain,” Kitay said. “I don’t think we can even begin to imagine the pain that they can experience. This is a community that needs more awareness and resources.”