Hematology and Oncology Book

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Acute Chest Syndrome

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  1. See Also
    1. Sickle Cell Anemia
  2. Precipitating Factors
    1. Sickle Cell Crisis
    2. Pulmonary infarction
    3. Acute fatty embolism
    4. Acute respiratory infection
      1. Bronchitis
      2. Pneumonia
      3. Legionella
      4. Mycoplasma pneumonia
  3. Symptoms
    1. Acute Chest Pain
    2. Wheezing
    3. Dyspnea
  4. Signs
    1. Fever
    2. Tachypnea
  5. Labs
    1. Complete Blood Count
    2. Serum chemistry panel
    3. Cultures (Blood Culture, Sputum Culture)
    4. Serum Protein Electrophoresis
      1. Hemoglobin-S before and after transfusion
  6. Monitoring
    1. Continuous pulse oximetry
      1. Arterial Blood Gas indicated for drop in oximetry
  7. .
  8. Imaging
    1. Chest XRay
      1. Acute infiltrate
  9. Management
    1. Oxygen to keep Oxygen Saturation >95%
    2. Incentive Spirometry
    3. Broad spectrum antibiotics
      1. Includes coverage for atypical respiratory bacteria
    4. Narcotic Analgesics
      1. See Sickle Cell Crisis for pain management
    5. Reactive airway disease management if present
  10. References
    1. Vichinsky (2000) N Engl J Med 342:1855

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