Risk factors for acute chest syndrome in children with sickle cell disease undergoing abdominal surgery

Kokoska, Evan R.; West, Karen W.; Carney, David E.; Engum, Scott; Heiny, Mark E.; Rescorla, Fred

doi:10.1016/j.jpedsurg.2004.02.027

Cited by 38 publications

(20 citation statements)

References 9 publications

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“…The mean length of postoperative stay in the current series for laparoscopic procedures was 3 days, which is similar to that reported in the literature [21,22]. Laparoscopic splenectomy has been shown to confer a clear benefit of shorter hospital stay when compared to open splenectomy in sickle cell children [22].…”

Section: Discussionsupporting

confidence: 86%

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Splenectomy reduces packed red cell transfusion requirement in children with sickle cell disease

Haricharan

Roberts

Morgan

et al. 2008

Journal of Pediatric Surgery

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Section: Discussionsupporting

confidence: 86%

“…Laparoscopic splenectomy has been shown to confer a clear benefit of shorter hospital stay when compared to open splenectomy in sickle cell children [22]. The rate of acute chest syndrome in the current series (6%) is toward the lower end of the published rates of acute chest syndrome after abdominal surgery (5%-15%) [21,22].…”

Section: Discussionmentioning

confidence: 69%

Splenectomy reduces packed red cell transfusion requirement in children with sickle cell disease

Haricharan

Roberts

Morgan

et al. 2008

Journal of Pediatric Surgery

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“…According to the literature, the mortality rate can be as high as 4% (1.8%-4%) [2]. The occurrence of ACS is inversely proportional to age, as it occurs more often in younger children [1].…”

Section: Discussionmentioning

confidence: 99%

Acute chest syndrome after splenectomy in children with sickle cell disease

Ghantous

Mulhim

Faris

et al. 2008

Journal of Pediatric Surgery

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“…6 We defined a clinical severity score (graded 0-5) based on the presence of different We determined the immunohematological profiles and immunization history, and classified DHTRs into 4 groups based on immunization status prior and after the triggering transfusion (TT): the first group included patients with no known previous immunization who developed antibodies (Abs) after the TT, in the second group patients were known as immunized and developed new Abs after the TT. In group 3, patients were not known as previously immunized and did not develop any detectable Abs after the TT.…”

Section: Methodsmentioning

confidence: 99%

Delayed hemolytic transfusion reaction in adult sickle‐cell disease: presentations, outcomes, and treatments of 99 referral center episodes

et al. 2016

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Delayed hemolytic transfusion reaction (DHTR) is one of the most feared complications of sickle-cell disease (SCD). We retrospectively analyzed the clinical and biological features, treatments and outcomes of 99 DHTRs occurring in 69 referral center patients over 12 years. The first clinical signs appeared a median of 9.4 [IQR, 3-22] days after the triggering transfusion (TT). The most frequent DHTR-related clinical manifestation was dark urine/hemoglobinuria (94%). Most patients (89%) had a painful vaso-occlusive crisis and 50% developed a secondary acute chest syndrome (ACS). The median [IQR] hemoglobin-concentration nadir was 5.5 [4.5-6.3] g/dL and LDH peak was 1335 [798-2086] IU/L. Overall mortality was 6%. None of the patients had been receiving chronic transfusions. Among these DHTRs, 61% were developed in previously immunized patients, 28% in patients with prior DHTR. Among Abs detected after the TT in 62% of the episodes, half are classically considered potentially harmful. No association could be established between clinical severity and immunohematological profile and/or the type and specificity of Abs detected after the TT. Management consisted of supportive care alone (53%) or with adjunctive measures (47%), including recombinant erythropoietin and sometimes rituximab and/or immunosuppressants. Additional transfusions were either ineffective or worsened hemolysis. In some cases, severe intravascular hemolysis can be likely responsible for the vascular reaction and high rates of ACS, pulmonary hypertension and (multi)organ failure. In conclusion, clinicians and patients must recognize early DHTR signs to avoid additional transfusions. For patients with a history of RBC immunization or DHTR, transfusion indications should be restricted. Am. J. Hematol. 91:989-994, 2016. © 2016 Wiley Periodicals, Inc.

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Risk factors for acute chest syndrome in children with sickle cell disease undergoing abdominal surgery

Cited by 38 publications

References 9 publications

Splenectomy reduces packed red cell transfusion requirement in children with sickle cell disease

Splenectomy reduces packed red cell transfusion requirement in children with sickle cell disease

Acute chest syndrome after splenectomy in children with sickle cell disease

Delayed hemolytic transfusion reaction in adult sickle‐cell disease: presentations, outcomes, and treatments of 99 referral center episodes

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