Blood transfusions for treating acute chest syndrome in people with sickle cell disease

Alhashimi, Dunia; Alhashimi, Fatima; Dastgiri, Saeed; Fedorowicz, Zbys; Nasser, Mona

doi:10.1002/14651858.cd007843

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…To determine the true risk ⁄ benefit ratio of exchange red blood cell transfusion in ACS, an adequately powered, randomized clinical trial is needed. Similarly, no randomized trials have shown the efficacy of blood transfusions in treating acute chest syndrome in patients with sickle cell disease (126).…”

Section: Transfusionmentioning

confidence: 99%

Acute chest syndrome: sickle cell disease

Paul

Castro

Aggarwal

et al. 2011

European Journal of Haematology

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Acute chest syndrome (ACS) is a common complication and reason for hospital admission in patients with sickle cell disease (SCD). It is also the most common cause of death in this patient population. Most of the time, the trigger for ACS in an individual patient cannot be identified. However, although infection is the most common identifiable cause for ACS, other important triggers are vaso‐occlusive crisis (VOC) and asthma. This comprehensive review will focus on the pathogenesis, clinical characteristics, complications and treatment available to manage ACS. But importantly, this review will highlight new possible etiologies, with the goal of improving oxygenation and, therefore, a reduction in sickling and lung damage in this patient population.

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Section: Transfusionmentioning

confidence: 99%

Acute chest syndrome: sickle cell disease

Paul

Castro

Aggarwal

et al. 2011

European Journal of Haematology

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“…acute anaemia, bilateral lung or multilobar involvement, decreasing platelet count, neurological signs) or evidence of progression despite initial simple transfusion . Whilst there is no randomized comparison of top‐up vs. exchange transfusion, evidence from observational studies suggests that blood transfusion may lead to rapid improvement in clinical and radiological abnormalities and early top‐up transfusion may prevent progression and a subsequent need for exchange transfusion .…”

Section: Role Of Blood Transfusion In the Treatment Of Acute Complicamentioning

confidence: 99%

Transfusion therapy for sickle cell disease

Howard

Robinson

2016

ISBT Science Series

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The clinical presentations of sickle cell disease include acute pain, acute chest syndrome, stroke and acute anaemia and blood transfusion therapy can be used effectively in the emergency setting for the treatment of many of these complications. Long‐term blood transfusion therapy is also used for the prevention of disease complications with most evidence for its use in primary stroke prevention. Transfusion can be given as a simple or top‐up transfusion or as an exchange transfusion and donor red cells should be haemoglobin S negative and as a minimum matched for ABO, full Rh and Kell type. Repeated transfusions lead to iron overload and appropriate monitoring and treatment should be provided. Alloimmunization is also a common complication of transfusion and can lead to haemolytic transfusion reactions.

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“…Dans les cas graves, la transfusion ou l'échange transfusionnel partiel restent le traitement le plus efficace pour diminuer la falciformation et améliorer les symptômes des patients [21,22]. Cependant, aucune étude randomisée n'a été effectuée dans ce domaine précis.…”

Section: Prise En Chargeunclassified

Le syndrome thoracique aigu : complication pulmonaire aiguë des patients adultes atteints d’un syndrome drépanocytaire majeur

Maître¹,

Habibi²,

Colin³

et al. 2015

Réanimation

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Le syndrome thoracique aigu (STA) est une des complications majeures des syndromes drépanocytaires et reste la principale cause de mortalité chez l'adulte. Il peut survenir chez des patients auparavant peu ou non symptomatiques, notamment chez ceux porteurs d'un syndrome drépa-nocytaire composite. Trois grandes causes dominent les étio-logies : les infections, l'obstruction vasculaire pulmonaire (par des emboles graisseux et/ou des thrombi fibrinocruoriques) et les hypoventilations alvéolaires secondaires à des suites chirurgicales ou des infarctus osseux. La symptomatologie associe fièvre, dyspnée et douleur thoracique. Elle survient souvent après quelques jours d'hospitalisation pour crise vaso-occlusive simple ou en postopératoire. L'imagerie retrouve des lésions alvéolaires condensantes des deux bases pulmonaires et la biologie une hémolyse associée à un syndrome inflammatoire. Il faut savoir rechercher deux facteurs de mauvais pronostic : un taux de plaquettes bas et surtout une insuffisance ventriculaire droite.Le traitement repose sur un trépied : hydratation, oxygé-nation et analgésie associés à une antibiothérapie couvrant les bactéries encapsulées et atypiques. Dans les formes sévè-res, le seul traitement spécifique est la transfusion ou l'exsanguinotransfusion suivant le taux d'hémoglobine. Une transfusion préventive ou un échange transfusionnel peuvent être discutés chez des patients à risque, notamment lors de circonstances particulières (grossesse, intervention chirurgicale). Cette décision sera prise au cas par cas en fonction des antécédents transfusionnels. Dans le cadre de la prévention, une spirométrie incitative doit toujours être prescrite pour les patients drépanocytaires hospitalisés, notamment pour crise vaso-occlusive. Mots clés Drépanocytose · Syndrome thoracique aigu · RéanimationAbstract Acute chest syndrome is the second most common reason for hospitalization and the leading cause for mortality in adult patients with sickle cell disease. This complication is not only observed in most severe patients, but can appear in previously non symptomatic patients. Three main mechanisms are involved: infection, vascular obstruction (by fat embolism and/or pulmonary artery thrombus), and alveolar hypoventilation secondary to surgery or to bone infarcts. The most frequent symptoms are fever, dyspnea, and thoracic pain. In half of patients, vaso-occlusive crisis can precede these symptoms. Basal alveolar consolidation is observed on lung imaging. Hemolysis and systemic inflammation are frequent biological findings. Two prognostic markers have been suggested in the litterature: thrombopenia and right ventricular dysfunction. Supportive treatments (oxygenation, rehydration, and analgesia) are usually prescribed with antibiotics. Transfusion and/or partial blood exchange depending on the haemoglobin level are used in the severe forms. Preventive transfusion should be discussed in specific conditions such as pregnancy and surgical procedure. Preventive incentive spirometry should also be implemented in...

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Blood transfusions for treating acute chest syndrome in people with sickle cell disease

Cited by 4 publications

References 20 publications

Acute chest syndrome: sickle cell disease

Acute chest syndrome: sickle cell disease

Transfusion therapy for sickle cell disease

Le syndrome thoracique aigu : complication pulmonaire aiguë des patients adultes atteints d’un syndrome drépanocytaire majeur

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