Emergency Medicine Management of Sickle Cell Disease Complications: An Evidence-Based Update

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• 作者：Erica Simon ; DO ; MHA^&lowast ; ; Brit Long ; MD^&lowast ; ; ; Alex Koyfman ; MD^&dagger ;
• 关键词：sickle cell disease ; acute chest ; acute pain crisis ; cerebrovascular accident ; transfusion
• 刊名：Journal of Emergency Medicine
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：51
• 期：4
• 页码：370-381
• 全文大小：964 K

文摘

Sickle cell disease (SCD) affects approximately 100,000 individuals in the United States. Due to alterations in the structural conformation of hemoglobin molecules under deoxygenated conditions, patients with SCD are predisposed to numerous sequelae, many of which require acute intervention.

Objective

Our aim was to provide emergency physicians with an evidence-based update regarding the diagnosis and management of SCD complications.

Discussion

SCD patients experience significant morbidity and mortality secondary to cerebrovascular accident, acute chest syndrome, acute vaso-occlusive pain crises, SCD-related multi-organ failure, cholecystitis, acute intrahepatic cholestasis, acute sickle hepatic crisis, acute hepatic sequestration, priapism, and renal disease. Emergency physicians must recognize acute manifestations of SCD in order to deliver timely management and determine patient disposition.

Conclusions

A comprehensive review of the emergency department management of acute SCD complications is provided. Comprehensive understanding of these aspects of SCD can assist physicians in expediting patient evaluation and treatment, thus decreasing the morbidity and mortality associated with this hemoglobinopathy.