Clinical management of the acute complications of sickle cell anemia: 11 years of experience in a tertiary hospital.

Autor:	Reparaz P; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain., Serrano I; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain., Adan-Pedroso R; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain., Astigarraga I; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain; Departamento de Pediatría, Universidad del País Vasco UPV/EHU, Spain., de Pedro Olabarri J; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain., Echebarria-Barona A; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain., Garcia-Ariza M; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain., Lopez-Almaraz R; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain., Del Orbe-Barreto RA; Servicio de Hematología y Hemoterapia, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain., Vara-Pampliega M; Servicio de Hematología y Hemoterapia, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain., Gonzalez-Urdiales P; Servicio de Pediatría, Hospital Universitario Cruces, Osakidetza, Barakaldo, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain. Electronic address: Paula.gonzalezurdiales@osakidetza.eus.
Jazyk:	angličtina
Zdroj:	Anales de pediatria [An Pediatr (Engl Ed)] 2022 Jul; Vol. 97 (1), pp. 4-11. Date of Electronic Publication: 2022 Jun 18.
DOI:	10.1016/j.anpede.2022.06.002
Abstrakt:	Introduction: Sickle cell disease is an emerging anemia in Europe leading to high morbidity with severe acute complications requiring hospital admission and chronic consequences. The management of these patients is complex and needs interdisciplinary care. The objective is to analyze clinical characteristics and management of patients with sickle cell disease admitted for acute complications. Methods: Retrospective descriptive study of admissions for acute complications of patients with sickle cell disease under 16 years of age in a tertiary hospital between 2010 and 2020. Clinical, laboratory and radiological data were reviewed. Results: We included 71 admissions corresponding to 25 patients, 40% diagnosed by neonatal screening. Admissions increased during this period. The most frequent diagnoses were vaso-occlusive crisis (35.2%), febrile syndrome (33.8%) and acute chest syndrome (32.3%). Nine patients required critical care at PICU. Positive microbiological results were confirmed in 20 cases, bacterial in 60%. Antibiotic therapy was administered in 86% of cases and the vaccination schedule of asplenia was adequately fulfilled by 89%. Opioid analgesia was required in 28%. Chronic therapy with hydroxyurea prior to admission was used in 41%. Conclusions: Acute complications requiring hospital admission are frequent in patients with sickle cell disease, being vaso-occlusive crisis and febrile syndrome the most common. These patients need a high use of antibiotics and opioid analgesia. Prior diagnosis facilitates the recognition of life-threatening complications such as acute chest syndrome and splenic sequestration. Despite the prophylactic and therapeutic measures currently provided to these patients, many patients suffer acute complications that require hospital management. (Copyright © 2021 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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