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Acute chest syndrome in children with severe sickle cell disease is common and life threatening. We outline a treatment pathway and discuss the more controversial areas such as steroid use and narcotic selection. Also some new research suggests early NIV could reduce transfusion requirements.
Most Recent References
Early noninvasive ventilation and nonroutine transfusion for acute chest syndrome in sickle cell disease in children: A descriptive study. Heilbronner C, Merckx A, Brousse V, Allali S, Hubert P, de Montalembert M, Lesage F. Pediatr Crit Care Med. 2018 May;19(5):e235-ee241. doi: 10.1097/PCC.0000000000001468
Management of Sickle Cell Disease Summary of the 2014 Evidence-based Report by Expert Panel Members. Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, Jordan L, Lanzkron SM, Lottenberg R, Savage WJ, Tanabe PJ, Ware RE, Murad MH, Goldsmith JC, Ortiz E, Fulwood R, Horton R, John-Sowah J. JAMA. 2014 Sep 10;312(10):1033-48. doi: 10.1001/jama.2014.10517.
Systemic Corticosteroids in Acute Chest Syndrome: Friend or Foe? Ogunlesi F, Heeney MM, Koumbourlis AC. Paediatr Respir Rev. 2013 Oct 31. pii: S1526-0542(13)00121-8.