Incentive Spirometry to Prevent Acute Pulmonary Complications in Sickle Cell Diseases

Pulmonary Complications of Sickle Cell Disease

“…Therapies reported to prevent ACS in at-risk patients include preoperative blood transfusion (42), maintenance asthma therapy for children with asthma (43), maintenance hydroxyurea therapy (14,44), and the use of incentive spirometry during acute VOC hospitalizations (14,17,45).…”

The Natural History of Sickle Cell Disease

“…Exchange transfusion can be lifesaving when rapid deterioration signals acute pulmonary sequestration. This syndrome may also follow hypoventilation associated with the pleuritic pain of avascular necrosis of the ribs or sternum and may be prevented by incentive spirometry in such cases (Bellet et al 1995). The acute chest syndrome is one of the commonest causes of death after the age of 2 yr.…”

Acute Chest Syndrome in Sickle Cell Disease

“…Infarction has been documented during sickle cell vaso-occlusive crisis and ACS by nuclear medicine techniques, and these infarctions are often in proximity to infiltrates on chest radiograph. [36][37][38] It is proposed that bone infarction during vaso-occlusive crisis leads to localized splinting, atelectasis, radiographic infiltrates, and ACS.…”

“…41 Pain control to prevent thoracic splinting and encourage good pulmonary toilet is important, but care must be taken to avoid excessive sedation that results in decreased ventilatory effort. 11,[36][37][38][39][40] The efficacy of supervised incentive spirometry in the treatment of atelectasis and prevention of ACS has been well documented, and spirometry should be used routinely to mitigate this problem. 38 Spirometry exercises performed 10 times every 2 hours between 8:00 am and 10:00 pm and while the patient is awake overnight have been shown to decrease the incidence of pulmonary infiltrates while in the hospital.…”

“…11,[36][37][38][39][40] The efficacy of supervised incentive spirometry in the treatment of atelectasis and prevention of ACS has been well documented, and spirometry should be used routinely to mitigate this problem. 38 Spirometry exercises performed 10 times every 2 hours between 8:00 am and 10:00 pm and while the patient is awake overnight have been shown to decrease the incidence of pulmonary infiltrates while in the hospital. 38 antibiotics All patients with ACS should receive antibiotics at presentation, which should include a third-generation cephalosporin to cover S. pneumoniae, H. influenzae, and K. pneumoniae, and a macrolide to cover M. pneumoniae and C. pneumoniae.…”