1 Fellow in Hematology and Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
The article, Anesthetic Risks in Sickle Cell Trait, is disconcerting because its conclusions are unjustified and its implications unwarranted. For example, due to the paucity of preoperative information one might conclude that the patients were doubly heterozyous for a hemoglobinopathy such as sickle thalassemia.
The presence of generalized sickling at postmortem exam in the five patients reported does not constitute proof that intravascular sickling was pathogenic in the patient's death, for it is obvious that red cells from a patient with sickle trait will assume the sickled shape in the acidotic and hypoxic postmortem state.