Acute chest syndrome medical therapy

Jump to: navigation, search

Acute chest syndrome Microchapters

Home

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Acute chest syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Acute chest syndrome medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Acute chest syndrome medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Acute chest syndrome medical therapy

CDC on Acute chest syndrome medical therapy

Acute chest syndrome medical therapy in the news

Blogs on Acute chest syndrome medical therapy

Directions to Hospitals Treating Acute chest syndrome

Risk calculators and risk factors for Acute chest syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical Therapy

Acute Pharmacotherapy

  • The primary goal is to prevent the development of ACS. It is therefore essential to vaccinate patients with the pneumococcal and haemophilus influenza B (HIB) vaccines and prevent hypoxemia.
  • The acute treatment of ACS is primarily supportive, and depends on the likelihood of the above diagnoses.
  • Antibiotics should be initiated, with the goal of covering the typical and atypical organisms that cause community acquired pneumonia.
  • Supplemental oxygen to maintain a PaO2 >70.
  • Hydration to prevent intravascular sickling are essential.
  • Pain control and incentive spirometry to avoid splinting is also important.
  • There is some data, however, that suggests that vigorous hydration in combination with narcotic analgesics can lead to pulmonary edema. Therefore, euvolemia should be the goal.
  • Empiric anticoagulant therapy is currently not recommended because of the risk of intracranial and renal bleeding.
  • Exchange transfusion is recommended in the setting of progressive infiltrates and hypoxemia, with a goal of reducing the Hb S level to below 30%, while keeping HCT ~30%.
  • Hydroxyurea has been associated with a 50% reduction in the frequency of developing both pain crises and ACS, and studies are underway examining its use in the acute treatment of patients with ACS.

Chronic Pharmacotherapy

The primary goal is to prevent the development of ACS. It is therefore essential to vaccinate patients with the pneumococcal and HIB vaccines and prevent hypoxemia.

References



Linked-in.jpg