Which statement best describes the role of hydration in preventing crises in sickle cell disease?

• A. Hydration has no effect
• B. Adequate hydration helps prevent stuck red blood cells
• C. Only intravenous hydration helps
• D. Extensive fluids contraindicated to prevent overload

Answer: (B)

Hydration helps prevent stuck red blood cells because keeping fluids adequate reduces the dehydration of red blood cells, which lowers the concentration of hemoglobin S inside the cells. When HbS is less concentrated, it polymerizes less readily, so the cells stay more flexible and less adhesive to the blood vessel walls. This decreases the likelihood of microvascular occlusion and vaso-occlusive crises. In practice, fluid intake supports plasma volume and tissue perfusion and can be oral or intravenous depending on the clinical situation. The idea isn’t that only intravenous fluids help, nor that fluids should always be excessive; rather, maintaining adequate hydration is a protective, modifiable factor against crisis.