Opioid selection during sickle cell pain crisis and its impact on the development of acute chest syndrome

Buchanan, Iris; Woodward, Maribel; Reed, George W.

doi:10.1002/pbc.20403

Cited by 73 publications

(48 citation statements)

References 22 publications

(24 reference statements)

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“…These results are in agreement with the study of Finkelstein Y et al, (2007) [35] who reported that, most of the children in their study presented to the emergency department for painful VOC and developed acute chest syndrome. Another studies conducted by Buchanan ID, et al, (2005) [36] and, Lewing 2011 [37] are also, consistent with the current results, they found that most of the children aged in their study suffering from VOC. They reported that, the incidence of Vaso occlusive crises and acute chest syndrome in patients presenting to hospital with a painful sickle cell episode were less than one third of the children suffering from SCC.…”

Section: Discussionsupporting

confidence: 80%

Empowering Mothers to Overcome Sickle Cell Crisis in Their Children through Engagement and Education

El-Gawad¹

2017

AJNR

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Background: Sickle cell anemia is a common disease in Saudi Arabia. It causes major crises to children who suffering from it. Empowerment refers to measures designed, to increase autonomy and self-determination through professional support and engagement and empowerment. Mothers education and engagement are critical components of high-quality and early care of children suffering from sickle cell crises (SCC). Aims: To empower mothers to manage SCC events experienced by their children. To educate the mothers and engage them in caring for their children and to evaluate the effect of engagement and education on mother's knowledge and performance regarding SCC. Study design: A quasi-experimental design was used. Individualized interview and small group teaching with pre and post evaluation was applied. Setting: The study was conducted in Pediatric Hematological Department at Maternity and Children Hospital, at Makkah Al-Mukararma. Subjects: A purposive sample composed of 40 mothers recruited according to certain inclusion and exclusion criteria. Tools: Two tools were used to collect data including, First: Interview Questionnaire sheet was used to collect mothers' socio-demographic characteristics. Second: empowerment scale, that consisted of 34 items within three construct areas family, services system and community. Results: Nearly two thirds of the mothers had poor knowledge regarding SCA pretest compared to one fifth of them posttest. Statistical significant differences regarding was found (P= 0.00). Improved mothers' performance was recognized post-test, most of the mothers, always give immunization, and enough oxygen. Three quarters of the mothers offer plenty of fluids to their children. Conclusion: Mothers knowledge and performance were improved after education and engagement. Mothers empowerment was very true "post-test" and there was statistical significant difference pre and posttest. There were significant positive correlations between mothers' age and their education, total knowledge, and total performance. Recommendations: Empowering and engaging mothers in caring for their children with SCA. Developing educational program for mothers about SCA and SCC.

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Section: Discussionsupporting

confidence: 80%

Empowering Mothers to Overcome Sickle Cell Crisis in Their Children through Engagement and Education

El-Gawad¹

2017

AJNR

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“…However, care should be taken to avoid alveolar hypoventilation of overdose, since it increases the risk of STA. Two studies have found that the use of morphine may increase a likelihood of developing STA [44,45]. However, a small cross-case study does not support these findings [46].…”

Section: Pain Controlcontrasting

confidence: 38%

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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“…58 It appears to be equianalgesic with morphine with fewer side effects; combination therapy with morphine also was found to be superior to either medication alone in a recent randomized trial of treatment for postoperative pain. 59 Optimizing pain control with decreased side effects, most critically ACS, should be a controlled trial priority; a prototype comparing 2 modes of administering patient-controlled analgesia was developed and piloted by the SCDRN (ClinicalTrials.gov ID NCT00999245).…”

Section: An Ounce Of Prevention Is Worth a Pound Of Cure (Henry De Bmentioning

confidence: 99%

How I treat acute chest syndrome in children with sickle cell disease

Miller

2011

Blood

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IntroductionAcute chest syndrome is (ACS) the second most common cause of hospitalization and challenges infection 1 as the leading cause of sickle cell-related mortality 2 in children. Still, management is largely determined by the experience of individual practitioners, and there are no conclusive randomized controlled clinical trials to guide therapy. What follows is a review of treatment options and related issues to assist in management; it will likely be especially useful to those who do not regularly encounter children with this potentially life-threatening complication.What is in a name? That which we call a rose by any other name would smell as sweet. (William Shakespeare)ACS is the term used to describe a new pulmonary infiltrate with respiratory findings in a person with sickle cell disease. 3 The etiology of these episodes is often multifactorial and difficult to discern. Although children may be more likely to have infectious etiologies for their chest syndrome and adults more likely sickle cell-related causes, 4,5 infection and inflammation may well induce sickling, and embolism/infarction may lead to superimposed infection. This is perhaps best illustrated by the fact that 2 common causes of ACS, Chlamydia pneumoniae and Mycoplasma pneumoniae, are associated with a severe clinical course in children with sickle cell disease 6-9 rather than the "walking pneumonia" that typifies infection in others. It thus makes no sense to try to differentiate between "pneumonia" and ACS.Chance is a word that does not make sense. Nothing happens without a cause. (Voltaire)The investigators of a multicenter National Acute Chest Syndrome Study (NACSS) 4 published in 2000 made aggressive attempts to identify etiology, including the performance of bronchoalveolar lavage (BAL) on consenting study enrollees; 72% of the 671 enrolled in the study had a lavage or sputum sample available. Despite these efforts, the authors only established potential causation in 38% overall and 70% of those with a complete assessment.The most common identifiable cause of ACS in this study was pulmonary fat embolism (PFE). 4 Originally described in trauma victims, PFE is a frequent complication of bone fracture and may progress to involve the lungs and CNS with multiorgan failure and death. 10,11 The NACSS made the diagnosis by using BAL to identify fat-laden macrophages; less-invasive means of making the diagnosis are not well established, and even the specificity of fat-laden macrophages in BAL specimens has been questioned. 12 Vichinsky et al, 13 in the first systematic, prospective search for PFE in sickle cell disease, found that 44% of patients with moderate-tosevere ACS had PFE as a probable etiology. These patients had longer, more severe hospital courses and a greater decrease in hemoglobin concentration and platelet count than those without fat emboli. Fat from bone marrow, which is typically infarcted during acute pain episodes, 14 embolizes to the lungs and, in its most extreme form, fat embolism syndrome may involve the brain, k...

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Opioid selection during sickle cell pain crisis and its impact on the development of acute chest syndrome

Cited by 73 publications

References 22 publications

Empowering Mothers to Overcome Sickle Cell Crisis in Their Children through Engagement and Education

Empowering Mothers to Overcome Sickle Cell Crisis in Their Children through Engagement and Education

Therapeutic Approaches of Acute Thoracic Syndrome in Patients with Falciform Disease

How I treat acute chest syndrome in children with sickle cell disease

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