Abstract

NARRATIVE REVIEW OF ACUTE CHEST SYNDROME

*Sneha Elisa Bency, Rini Sara John, Dr. Jiji Alfred

ABSTRACT

Acute chest syndrome (ACS), fatal consequence of sickle cell disease, is characterized by a new pulmonary infiltrate on chest imaging, respiratory symptoms (such as cough, tachypnea, dyspnea, and chest discomfort), fever, and/or hypoxemia. Vaso-occlusion in the pulmonary microvasculature, which is often caused by infection, pulmonary infarction, or bone-marrow fat embolism, is a primary cause of death for sickle cell patients. The clinical and radiographic diagnosis is supported by blood testing and microbiological analysis. Prompt hospitalization and aggressive supportive care are necessary for management, including supplemental oxygen to maintain appropriate saturations, IV fluid therapy to prevent dehydration and volume overload, broad-spectrum antibiotics covering both typical and atypical pathogens, effective analgesia to facilitate deep breathing and pulmonary toilet, incentive spirometry and early mobilization to prevent atelectasis, and timely transfusion therapy (simple or exchange) in hypoxic or deteriorating patients. Extracorporeal assistance and invasive or non-invasive ventilation may be necessary in severe situations. Morbidity, mortality, and recurrence are decreased by early detection, standardized procedures, and long-term disease-modifying treatment.

Keywords: Acute Chest Syndrome, Sickle cell disease, Respiratory symptoms, Broad-spectrum antibiotics, Pulmonary microvascular blockage, Hypoxia.