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sickle cell disease in ICU

Keyvan Razazi, Jean-François Deux, Nicolas de Prost, Florence Boissier, Elise Cuquemelle, Frédéric Galactéros, Alain Rahmouni, Bernard Maître, Christian Brun-Buisson, Armand Mekontso Dessap
Lung ultrasound (LU) is increasingly used to assess pleural and lung disease in intensive care unit (ICU) and emergency unit at the bedside. We assessed the performance of bedside chest radiograph (CR) and LU during severe acute chest syndrome (ACS), using computed tomography (CT) as the reference standard. We prospectively explored 44 ACS episodes (in 41 patients) admitted to the medical ICU. Three imaging findings were evaluated (consolidation, ground-glass opacities, and pleural effusion). A score was used to quantify and compare loss of lung aeration with each technique and assess its association with outcome...
February 2016: Medicine (Baltimore)
Susan E Creary, Deena J Chisolm, Terah L Koch, Victoria A Zigmont, Bo Lu, Sarah H O'Brien
BACKGROUND: Expert guidelines recommend that hydroxyurea (HU) be offered to all children with hemoglobin SS and Sβ(0) sickle cell disease (SCD) and be considered for children with clinically severe hemoglobin SC or Sβ(+) . This study aims to determine the rate of HU use in hospitalized children, if HU is differentially used in children with clinically severe SCD, and if HU users have shorter length of stay (LOS), fewer intensive care unit (ICU) admissions, and fewer inpatient transfusions compared to nonusers...
May 2016: Pediatric Blood & Cancer
Jérôme Cecchini, Muriel Fartoukh
PURPOSE OF REVIEW: The review focuses on severe acute vaso-occlusive manifestations of sickle cell disease leading adult patients to the ICU. RECENT FINDINGS: Careful consideration should be paid to look for pulmonary vascular dysfunction and acute kidney injury, because of their prognostic role during acute vaso-occlusive manifestations. Alloimmunization and delayed haemolytic transfusion reactions are emerging complications that should be thought to be diagnosed, as they may imply a conservative management...
December 2015: Current Opinion in Critical Care
Jean L Raphael, Troy Richardson, Matt Hall, Suzette O Oyeku, David G Bundy, Ram V Kalpatthi, Samir S Shah, Angela M Ellison
OBJECTIVE: To assess the relationship between hospital volume and intensive care unit (ICU) transfer among hospitalized children with sickle cell disease (SCD). STUDY DESIGN: We conducted a retrospective cohort study of 83,477 SCD-related hospitalizations at children's hospitals (2009-2012) using the Pediatric Health Information System database. Hospital-level all-cause and SCD-specific volumes were dichotomized (low vs high). Outcomes were within-hospital ICU transfer (primary) and length of stay (LOS) total (secondary)...
December 2015: Journal of Pediatrics
Coretta M Jenerette, Bosny J Pierre-Louis, Nadine Matthie, Yasmeen Girardeau
Individuals with sickle cell disease (SCD) have reported being stigmatized when they seek care for pain. Nurse attitudes contribute to stigmatization and may affect patients' response to sickle cell cues, care-seeking, and ultimately patient outcomes. The purpose of this cross-sectional, descriptive, comparative design study was to determine whether there are significant differences in nurse attitudes toward patients with SCD by worksite-medical-surgical units compared with emergency departments/intensive care units (ED/ICU)...
June 2015: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Nicolas de Prost, Myriam Sasanelli, Jean-François Deux, Anoosha Habibi, Keyvan Razazi, Frédéric Galactéros, Michel Meignan, Bernard Maître, Christian Brun-Buisson, Emmanuel Itti, Armand Mekontso Dessap
The acute chest syndrome (ACS) is the main cause of mortality among adult patients with sickle cell disease (SCD). Its pathophysiology is still unclear. Using positron emission tomography (PET) with F-fluorodeoxyglucose [18F-fluorodeoxyglucose (F-FDG)], we explored the relationship between regional lung density and lung metabolism, as a reflection of lung neutrophilic infiltration during ACS.Patients were prospectively enrolled in a single-center study. Dual modality chest PET/computed tomography (CT) scans were performed, with F-FDG emission scans for quantification of regional F-FDG uptake and CT scans with radiocontrast agent to check for pulmonary artery thrombosis...
May 2015: Medicine (Baltimore)
Damien Contou, Armand Mekontso Dessap, Guillaume Carteaux, Christian Brun-Buisson, Bernard Maitre, Nicolas de Prost
Acute chest syndrome (ACS) is the leading cause of ICU admission in patients with sickle cell disease and is characterized by golden sputum, which is commonly attributed to the presence of bilirubin. Three young consecutive patients with homozygous sickle cell disease were admitted for severe acute respiratory syndrome due to ACS. In all 3 patients, tracheal secretions and bronchoalveolar lavage fluid (BALF) showed a yellowish plasma-like stain. After normalization for the plasma-to-BAL urea ratio, BALF protein and lactate dehydrogenase levels were consistent with an exudative process...
April 2015: Respiratory Care
Jérôme Cecchini, François Lionnet, Michel Djibré, Antoine Parrot, Katia Stankovic Stojanovic, Robert Girot, Muriel Fartoukh
OBJECTIVE: Sickle cell disease is associated with a decreased life expectancy, half of the deaths occurring in the ICU. We aimed to describe the characteristics of sickle cell disease patients admitted to ICU and to identify early predictors of a complicated outcome, defined as the need for vital support or death. DESIGN: Retrospective observational cohort study of sickle cell disease patients over a 6-year period. SETTING: ICU of a French teaching hospital and sickle cell disease referral center...
July 2014: Critical Care Medicine
Dipesh Uprety, Aurangzeb Baber, Maria Foy
This article reports a rare case of the use of low-dose ketamine infusion as an adjuvant to opioids to treat pain in sickle cell disease. A 31-year-old African-American male with history of sickle cell disease presented to the emergency department with complaints of chest tightness, multiple joint pain, and headache for 1 week. His vital signs and physical examination were unremarkable. His admission lab included hemoglobin of 8.4 g/dl, reticulocyte count of 16.3%, bilirubin of 1.7 mg/dl, and LDH of 1,267 U/l...
May 2014: Annals of Hematology
Marc N Baskin, Xin Lyn Goh, Matthew M Heeney, Marvin B Harper
BACKGROUND AND OBJECTIVES: Previous studies have indicated that febrile children with sickle cell disease (SCD) had a 3% to 5% risk of being bacteremic due to compromised immune function. The introduction of routine penicillin prophylaxis and conjugate vaccines may have lowered the risk of bacteremia. Our goals were to determine the rate of bacteremia among children with SCD per febrile episode and to estimate the safety of outpatient management among these febrile SCD patients. METHODS: This 18-year retrospective cohort study included febrile SCD patients who presented to Boston Children's Hospital between 1993 and 2010...
June 2013: Pediatrics
Qutaiba Amir Tawfic, Rajini Kausalya, Dhuha Al-Sajee, Jyoti Burad, Ahmed K Mohammed, Aravind Narayanan
OBJECTIVES: Sickle cell disease (SCD) is an inherited disease caused by an abnormal type of haemoglobin. It is one of the most common genetic blood disorders in the Gulf area, including Oman. It may be associated with complications requiring intensive care unit (ICU) admission. This study investigated the causes of ICU admission for SCD patients. METHODS: This was a retrospective analysis of all adult patients ≥12 years old with SCD admitted to Sultan Qaboos University Hospital (SQUH) ICU between 1st January 2005 and 31st December 2009...
May 2012: Sultan Qaboos University Medical Journal
Albadio Pérez, Omar Acevedo, Felicia del Consuelo Tamayo, Regino Oviedo
INTRODUCTION: Most obstetric patients admitted to intensive care units (ICU) present life-threatening complications of pregnancy, delivery, and postpartum, often leading to multiple organ failure (MOF), considered the main cause of death in ICUs. Although maternal mortality is an important indicator of health status in women and nations, few studies have analyzed MOF in obstetric ICU patients. The Sequential Organ Failure Assessment (SOFA) scale is a prognostic tool for ranking organ dysfunction in critically ill patients and correlating scores with outcome...
2010: MEDICC Review
C T P Paul Krediet, Joost B L Hoekstra, J K M Sjef Gevers, Suzanne E Geerlings
In-hospital adult cardiopulmonary resuscitation is successful in only approximately 20% of cases and may result in permanent neurological damage. Two reasons justify not commencing resuscitation: either the patient does not want to be resuscitated, or resuscitation is considered medically futile by the doctor. This subject should be discussed timely with all chronically ill patients who are likely to be admitted to hospital, preferably in the outpatient clinic setting, and results must be communicated with all doctors involved (e...
2010: Nederlands Tijdschrift Voor Geneeskunde
Amy Sobota, Dionne A Graham, Matthew M Heeney, Ellis J Neufeld
Acute chest syndrome (ACS) causes significant morbidity and mortality in sickle cell disease. The role of corticosteroids is unclear. The objectives of our study were to examine the variation between hospitals in their use of corticosteroids for ACS, describe characteristics associated with corticosteroids, and investigate the association between corticosteroids, length of stay, and readmission. We performed a retrospective examination of 5,247 hospitalizations for ACS between January 1, 2004, and June 30, 2008, at 32 hospitals in the Pediatric Health Information System database...
January 2010: American Journal of Hematology
Mariam A Al-Ansari, Akmal A Hameed, Suhaila E Al-jawder, Hassan M Saeed
Mechanical ventilation is commonly required in critically ill pregnant patients, requiring ICU admission, with higher morbidity and mortality related to airway management. Alternatively, noninvasive positive pressure ventilation (NIPPV) is increasingly used to treat nonpregnant patients. Pregnancy has been a contraindication to its use. We would like to report a case series of successful use of NIPPV in pregnancy.NIPPV is increasingly used to treat hypoxemic respiratory failure. It has rarely been used during pregnancy...
January 2007: Annals of Thoracic Medicine
Salim Ghantous, Saad Al Mulhim, Nafeesa Al Faris, Basel Abushullaih, Firas Shalak, Salam Yazbeck
BACKGROUND/PURPOSE: The purpose of this study was to determine the incidence of acute chest syndrome (ACS) in children with sickle cell disease (SCD) undergoing laparoscopic or open splenectomy and to assess factors that may predispose to this complication. METHODS: A retrospective review of all patients with SCD undergoing splenectomy between 1999 and 2007 in our institution. Charts were screened for demographics, perioperative clinical status (vaso-occlusive crises, sequestration crises), preoperative hemoglobin electrophoresis and preoperative transfusion, postoperative development of ACS, and need for an intensive care unit (ICU) admission...
May 2008: Journal of Pediatric Surgery
Hayden White, Balasubramanian Venkatesh
OBJECTIVE: Transcranial Doppler (TCD) ultrasonography is a technique that uses a hand-held Doppler transducer (placed on the surface of the cranial skin) to measure the velocity and pulsatility of blood flow within the intracranial and the extracranial arteries. This review critically evaluates the evidence for the use of TCD in the critical care population. DISCUSSION: TCD has been frequently employed for the clinical evaluation of cerebral vasospasm following subarachnoid haemorrhage (SAH)...
July 2006: Intensive Care Medicine
Michael Oppert, Achim Jörres, Detlef Barckow, Kai-Uwe Eckardt, Ulrich Frei, Udo Kaisers
A 36-year-old male with a known history of sickle cell disease (SCD) and acute chest syndrome (ACS) was treated in our hospital. Gas exchange deteriorated and the patient was transferred to our intensive care unit (ICU). Low dose inhaled nitric oxide (iNO) during pressure controlled mechanical ventilation (pcMV) induced a clinically relevant increase in arterial oxygenation. The patient was weaned from pcMV after five days and discharged home 14 days later. ACS evolving to acute respiratory distress syndrome (ARDS) is a rare but severe complication...
March 20, 2004: Swiss Medical Weekly
B C McLeod
Therapeutic apheresis is a generic term that refers to removal of abnormal blood cells and plasma constituents. The terms "plasmapheresis," "leukapheresis," and "erythrocytapheresis" describe the specific blood element that is removed. Apheresis therapies can be performed in the ICU to manage a number of neurologic, hematologic, and autoimmune disorders, including myasthenia gravis, Guillain-Barré syndrome, sickle-cell disease, and Goodpasture's syndrome. Apheresis procedures generally require two points of contact with the circulation--one for blood withdrawal and one for return; the withdrawal site should sustain a flow rate of at least 50 mL/min...
May 1991: Journal of Critical Illness
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