UMEM Educational Pearls

Category: Critical Care

Title: Acute Chest Syndrome

Keywords: acute chest syndrome, blood transfusion, respiratory failure (PubMed Search)

Posted: 11/13/2007 by Mike Winters, MD (Updated: 7/10/2020)
Click here to contact Mike Winters, MD

  • Acute chest syndrome (ACS) is the leading cause of death in sickle cell patients
  • ACS is defined by the presence of a new infiltrate and one of the following: chest pain, wheezing, fever, tachypnea, or cough
  • Early and aggressive therapy is needed to minimize mortality
  • Up to 50% of patients develop respiratory failure
  • Treatment
    • Broad spectrum antibiotics - including a macrolide
    • Pain control to reduce hypoventilation
    • Early use of blood transfusion to improve O2 carrying capacity
    • Incentive spirometry
    • Bronchodilators if wheezing present
    • Hematology consult