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

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

doi:10.1002/14651858.cd007843.pub2

Cited by 26 publications

(18 citation statements)

References 27 publications

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“…There have been no randomized controlled trials comparing either simple or exchange transfusion versus no transfusion in patients with SCD and ACS. 20 However, transfusion therapy improves oxygenation within 12 to 24 hours of RBC administration 21 and, in a large epidemiologic study of ACS, management with transfusion was associated with a shorter duration of hospitalization. 22 In this same study, nearly three-quarters of the patients received transfusions at the discretion of the treating physician, 22 demonstrating its widely accepted use.…”

Section: Acute Chest Syndromementioning

confidence: 99%

Transfusion therapy for sickle cell disease: a balancing act

Chou

2013

Hematology

108

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Transfusion therapy is a key intervention in decreasing morbidity and mortality in patients with sickle cell disease (SCD). Current indications for acute and chronic transfusion therapy have significantly increased the number of RBC units transfused to patients with SCD worldwide. This review summarizes transfusion management for the treatment or prevention of neurologic and perioperative complications, acute chest syndrome, and acute anemia associated with SCD. Despite the recognized benefits of transfusion therapy, it is not without the risks of iron overload, alloimmunization, and delayed hemolytic transfusion reactions. Transfusional iron overload management includes automated RBC exchange, noninvasive imaging to monitor iron burden, and iron chelation with parenteral or oral agents. Although limited and extended RBC antigen matching reduces antibody formation, the prevalence of RBC alloimmunization in patients with SCD remains high. Recent studies demonstrate that RH genetic diversity in patients with SCD contributes to Rh alloimmunization, suggesting that even more refined RBC matching strategies are needed. Advances in molecular blood group typing offer new opportunities to improve RBC matching of donors and recipients and can be of particular benefit to patients with SCD.

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Section: Acute Chest Syndromementioning

confidence: 99%

Transfusion therapy for sickle cell disease: a balancing act

Chou

2013

Hematology

108

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“…Therefore all patients with the syndrome should receive broad spectrum parenteral antibiotics consisting of third generation cephalosporins such as penicillin's and macrolides such as azithromycin [34]. The antibiotic treatment regimen may further be modified depending on the culture results and the clinical condition of the patient [14,34]. For pregnant women at risk or at the beginning of untreated disease, the indicated antibiotic is vancomycin [7].…”

Section: Therapeutic Approachesmentioning

confidence: 99%

“…For pregnant women at risk or at the beginning of untreated disease, the indicated antibiotic is vancomycin [7]. There are no guidelines available for optimal therapy with antibiotics in STA treatment, but a 10-day course seems to be a reasonable option [31,34].…”

Section: Therapeutic Approachesmentioning

confidence: 99%

“…Acute respiratory failure can develop abruptly, since early blood transfusion of the simple type when hemoglobin levels are less than 50 g/L is extremely important because it aims to achieve an ideal concentration of 100-110 g/L. Although most STA patients respond adequately to simple transfusions, some studies show an efficacy of transfusion transfusions as first-line therapy in STA [33][34][35][36]. Blood transfusion does not occur frequently, and your choice should be based on the patient's clinical status, noting that the patient is deteriorating relatively quickly.…”

Section: Transfusionmentioning

confidence: 99%

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Therapeutic Approaches of Acute Thoracic Syndrome in Patients with Falciform Disease

Ac¹,

Costa²,

Tec³

et al. 2017

J Blood Lymph

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Sickle cell disease (SCD) is an autosomal recessive inheritance disorder that affects the beta-globin gene and results in the replacement of the amino acid glutamic acid by valine in the β chain of the hemoglobin molecule, producing erythrocytes with defective forms and functions. A range of pathological conditions is associated with SCD, however, one in particular stands out by gravity. Acute thoracic syndrome (STA), characterized by the presence of pulmonary infiltrates associated with a clinical symptom such as chest pain, cough, wheezing, tachypnea and fever, is considered a leading cause of death in patients with sickle cell disease. Early diagnosis and introduction of an effective approach to complication are needed to improve outcomes and minimize associated morbidity and mortality. Risk factors associated with STA in the SCDAbdominal surgery for splenectomy and cholecystectomy [19] Hypersensitivity [20,21] Smoking [20,21] Asthma [22] Infections [9,[23][24][25] Post-Surgical Hypoventilation [9,[23][24][25] Fatty Embolism [9,[23][24][25]

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“…Because most patients with ACS drop their hemoglobin, it is usually feasible to transfuse two to four units in the first 24 hours and then maintain hemoglobin levels at 10 to 11 g/dl with subsequent transfusions. However, in severe or rapidly progressive illness, exchange transfusion is advised (48). It should be noted that one of the major iatrogenic complications in the treatment of ACS is transfusion of alloreactive blood.…”

Section: Acs Treatmentmentioning

confidence: 99%

Pulmonary Complications of Sickle Cell Disease

Firth

2009

N Engl J Med

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Sickle cell disease (SCD) is a common monogenetic disorder with high associated morbidity and mortality. The pulmonary complications of SCD are of particular importance, as acute chest syndrome and pulmonary hypertension have the highest associated mortality rates within this population. This article reviews the pathophysiology, diagnosis, and treatment of clinically significant pulmonary manifestations of SCD, including acute chest syndrome, asthma, and pulmonary hypertension in adult and pediatric patients. Clinicians should be vigilant in screening and treating such comorbidities to improve patient outcomes.

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

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

Cited by 26 publications

References 27 publications

Transfusion therapy for sickle cell disease: a balancing act

Transfusion therapy for sickle cell disease: a balancing act

Therapeutic Approaches of Acute Thoracic Syndrome in Patients with Falciform Disease

Pulmonary Complications of Sickle Cell Disease

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