Title: Sickle Cell Disease in the ICU<br/>Author: Michael Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>Acute Chest Syndrome</u></strong></p>
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Acute chest syndrome (ACS) accounts for the most common cause of ICU admission and the most common cause of death in sickle cell patients.</li>
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Important pearls for ACS include:
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<em>Chlamydophila pneumonia</em> is the most common bacterial cause of ACS in adults, whereas <em>Mycoplasma pneumonia </em>is the most common bacterial cause in children.</li>
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CXR abnormalities may be absent early in disease.</li>
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Children are more likely to have middle lobe disease, in contrast to adults who often have lower lobe involvement.</li>
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Acute RV failure is a well recognized complication of ACS - use ultrasound to evaluate the RV and be careful with fluids.</li>
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<fieldset><legend>References</legend>
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Cecchini J, Fartoukh M. Sickle cell disease in the ICU. <em>Curr Opin Crit Care</em> 2015; 21:569-75.</p>
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