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dc.contributor.authorWang, Kevineng
dc.contributor.authorDas-Ireland, Monishaeng
dc.date.issued2022-10eng
dc.descriptionCorresponding author: Kevin Wangeng
dc.description.abstractIntroduction: Acute Chest Syndrome (ACS) is a leading complication of sickle cell disease (SCD) with significant morbidity and mortality. The current practice guidelines lack sufficient detail on the evidence behind our standard of practice. Materials and Methods: A comprehensive literature search was accomplished with PubMed with a particular focus on literatures published between 2015-2021 with the keywords ACS management, vaso-occlusive crisis, sickle cell, antibiotics, opioids, transfusion, fluid, steroids, bronchodilators, incentive spirometry, anticoagulation, oxygen, prevention, and SARS-CoV2. We included literatures both in the adult and pediatric population. Results/Discussion: ACS is defined as a new infiltrate in a chest radiograph involving at least one broncho-pulmonary segment in an individual with one additional clinical finding. There are multiple causes of ACS which include infections, pulmonary edema, hypoxemia, and hypoventilation. The goal is to quickly diagnose and treat this condition to prevent irreversible lung damage and mortality. In this narrative review, we discuss why a balanced approach to fluid and pain management will provide better outcomes for patients, and the evidence behind using antibiotics, steroids, bronchodilators, nitric oxide, incentive spirometry, as well as the current management of patients with concomitant ACS and SARS-CoV2. Conclusions: All patients admitted with ACS should be started on a third-generation cephalosporin and macrolide or a fourth-generation fluoroquinolone, incentive spirometry, thromboprophylaxis, oxygen, and simple or exchange transfusion if needed, with a balanced approach to fluid resuscitation and pain control.eng
dc.description.bibrefIncludes bibliographical references.eng
dc.description.statementofresponsibilityKevin Wang, DO (Department of Internal Medicine, University of Missouri – Kansas City School of Medicine), Monisha Das-Ireland (Department of Pulmonary-Critical Care, University of Missouri – Kansas City School of Medicine)eng
dc.format.extent11 pageseng
dc.identifier.citationAm j Hosp Med 2022 Oct;6(4): 2022.
dc.identifier.urihttps://hdl.handle.net/10355/94706
dc.identifier.urihttps://doi.org/10.24150/ajhm/2022.013eng
dc.languageEnglisheng
dc.publisherUniversity of Missouri, Department of Medicine, Division of Hospital Medicineeng
dc.relation.ispartofAmerican journal of hospital medicine, volume 6, issue 4 (2022 Oct-Dec)eng
dc.relation.ispartofseriesRevieweng
dc.rightsOpenAccess.eng
dc.rights.licenseThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License.
dc.sourceHarvested from the American Journal of Hospital Medicine website (https://medicine.missouri.edu/departments/medicine/divisions/hospital-medicine/american-journal-of-hospital-medicine) in 2023.eng
dc.subjectacute chest syndrome ; sickle cell disease ; vaso-occlusive crisis ; opioid ; antibiotics ; transfusion ; consolidationeng
dc.titleAcute chest syndrome : a narrative review to guide inpatient managementeng
dc.typeArticleeng


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