Arginine Therapy for Sickle Cell Disease Pain

Exclusion Criteria

• •Decision to discharge home from the acute care setting
• •Hemoglobin less than 5 gm/dL or immediate need for red cell transfusion anticipated within next 12 hours
• •Hepatic dysfunction of SGPT greater than 3 times the upper value
• •Renal dysfunction of creatinine greater than 1.0
• •Mental status or neurological changes
• •Acute stroke or clinical concern for stroke
• •Pregnancy
• •Allergy to arginine
• •Two (2) or more ED visits for VOE within the last 7 days prior to CURRENT ED visit
• •Hospitalization within 14 days
• •Previous randomization in this arginine RCT (patient consented and screen failed before receiving study drug or placebo remains eligible for future participation).
• •Use of inhaled nitric oxide, sildenafil or arginine within the last month
• •PICU admission from the emergency department
• •Hypotension requiring treatment with clinical intervention
• •Acidosis with Co2≤ 16
• •Newly started on HU for \<3 months
• •Not an appropriate candidate in the investigator's judgment
• •Patient refusal