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How I treat acute chest syndrome in children with sickle cell disease
How I treat acute chest syndrome in children with sickle cell disease
- Source :
- Blood. 117(20)
- Publication Year :
- 2011
-
Abstract
- Acute chest syndrome describes new respiratory symptoms and findings, often severe and progressive, in a child with sickle cell disease and a new pulmonary infiltrate. It may be community-acquired or arise in children hospitalized for pain or other complications. Recognized etiologies include infection, most commonly with atypical bacteria, and pulmonary fat embolism (PFE); the cause is often obscure and may be multifactorial. Initiation of therapy should be based on clinical findings. Management includes macrolide antibiotics, supplemental oxygen, modest hydration and often simple transfusion. Partial exchange transfusion should be reserved for children with only mild anemia (Hb > 9 g/dL) but deteriorating respiratory status. Therapy with corticosteroids may be of value; safety, efficacy and optimal dosing strategy need prospective appraisal in a clinical trial. On recovery, treatment with hydroxyurea should be discussed to reduce the likelihood of recurrent episodes.
- Subjects :
- Pediatrics
medicine.medical_specialty
Anemia
medicine.medical_treatment
Immunology
Pneumonia, Viral
Exchange Transfusion, Whole Blood
Exchange transfusion
Embolism, Fat
Anemia, Sickle Cell
Biochemistry
Adrenal Cortex Hormones
Recurrence
Acute Chest Syndrome
Pneumonia, Mycoplasma
medicine
Pneumonia, Bacterial
Humans
Blood Transfusion
Fat embolism
Intensive care medicine
Child
business.industry
Cell Biology
Hematology
Chlamydia Infections
Chlamydophila pneumoniae
medicine.disease
Acute chest syndrome
Sickle cell anemia
Clinical trial
Pneumonia
Embolism
business
Pulmonary Embolism
Subjects
Details
- ISSN :
- 15280020
- Volume :
- 117
- Issue :
- 20
- Database :
- OpenAIRE
- Journal :
- Blood
- Accession number :
- edsair.doi.dedup.....eb66f7af866bc3c090d0d7419dd183c2