Perioperative Management of Sickle Cell Disease

Mediterranean Journal of Hematology and Infectious Diseases
Kwame Ofori AdjepongYaw Amoateng Adjepong

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.

Citations

Aug 29, 2019·American Journal of Hematology·Frederica SchyrrRaffaele Renella
Mar 13, 2021·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Xiaolin SunYang Yu
Oct 5, 2020·Journal of Pediatric Surgery·Christopher W SnyderNicole M Chandler
Jun 8, 2021·World Journal of Otorhinolaryngology - Head and Neck Surgery·Ryan Ruiz, Kavita Dedhia
Dec 11, 2021·Hematology·Charity I Oyedeji, Ian J Welsby
Dec 11, 2021·Hematology·Hyojeong HanVenée N Tubman

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