Perioperative Management of Sickle Cell Disease

Document Type

Article

Publication Title

Mediterranean journal of hematology and infectious diseases

Abstract

Over 30 million people worldwide have sickle cell disease (SCD). Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlusive (painful) crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include a careful review of the patient's known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and opioid use. Use of preoperative blood transfusions should be selective and decisions individualized based on the baseline hemoglobin, surgical procedure and anticipated volume of blood loss. Intra- and post-operative management should focus on minimizing hypoxia, hypothermia, acidosis, and intravascular volume depletion. Pre- and post-operative incentive spirometry use should be encouraged.

First Page

e2018032

DOI

10.4084/MJHID.2018.032

Publication Date

1-1-2018

Identifier

29755709 (pubmed); PMC5937979 (pmc); 10.4084/MJHID.2018.032 (doi); mjhid-10-1-e2018032 (pii)

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