ICU SAQs · Haematology / haemoglobinopathy
Acute chest syndrome in sickle-cell disease — the leading cause of death
A CICM SAQ on acute chest syndrome — oxygen, antibiotics including a macrolide, incentive spirometry, simple versus exchange transfusion, and ACS as the leading cause of death.
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Prompt
A 25-year-old with sickle-cell disease develops fever, hypoxia (SpO2 88 on room air), and a new right-lower-lobe infiltrate. Discuss the diagnosis and management.
Question
A 25-year-old with sickle-cell disease develops fever, hypoxia (SpO2 88 on room air), and a new right-lower-lobe infiltrate. Discuss the diagnosis and management.[1]
References5ShowHide
- [1]Vichinsky EP, Neumayr LD, Earles AN, et al. Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group N Engl J Med, 2000.PMID 10861320
- [2]Biller E, Zhao Y, Berg M, et al. Red blood cell exchange in patients with sickle cell disease-indications and management: a review and consensus report by the therapeutic apheresis subsection of the AABB Transfusion, 2018.PMID 30198607
- [3]Bellet PS, Kalinyak KA, Shukla R, Gelfand MJ, Rucknagel DL Incentive spirometry to prevent acute pulmonary complications in sickle cell diseases N Engl J Med, 1995.PMID 7637747
- [4]Yawn BP, Buchanan GR, Afenyi-Annan AN, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members JAMA, 2014.PMID 25203083
- [5]Neumayr L, Lennette E, Kelly D, et al. Mycoplasma disease and acute chest syndrome in sickle cell disease Pediatrics, 2003.PMID 12837872