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Acute Chest Syndrome

Respiratory syndrome characterized by the appearance of a new pulmonary infiltrate on chest x-ray, accompanied by symptoms of fever, cough, chest pain, tachypnea, or DYSPNEA, often seen in patients with SICKLE CELL ANEMIA. Multiple factors (e.g., infection, and pulmonary FAT EMBOLISM) may contribute to the development of the syndrome.
Also Known As:
Acute Chest Syndromes; Syndrome, Acute Chest; Syndromes, Acute Chest
Networked: 416 relevant articles (27 outcomes, 50 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1. Sickle Cell Anemia (Hemoglobin S Disease)
2. Pain (Aches)
3. Osteonecrosis (Kienbock's Disease)
4. Pulmonary Hypertension
5. Stroke (Strokes)

Experts

1. Casella, James F: 9 articles (01/2020 - 11/2006)
2. Wang, Winfred C: 9 articles (01/2020 - 10/2003)
3. Miller, Scott T: 9 articles (10/2013 - 10/2003)
4. Knight-Madden, Jennifer M: 8 articles (01/2019 - 07/2012)
5. DeBaun, Michael R: 8 articles (11/2018 - 11/2006)
6. Gordeuk, Victor R: 7 articles (01/2022 - 08/2008)
7. Habibi, Anoosha: 7 articles (01/2022 - 01/2007)
8. Estcourt, Lise J: 7 articles (01/2020 - 04/2016)
9. Hopewell, Sally: 7 articles (01/2020 - 04/2016)
10. Romana, Marc: 7 articles (01/2020 - 09/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Acute Chest Syndrome:
1. Hydroxyurea (Hydrea)FDA LinkGeneric
03/01/2013 - "Hydroxyurea has documented laboratory efficacy with increases in Hb and HbF; treatment also significantly reduces the number of painful episodes, acute chest syndrome, transfusions, and hospitalizations. "
09/30/2021 - "The close temporal relationship between the increased use of hydroxyurea and the reduction in the incidence of acute chest syndrome in a representative population-based analysis implies that these changes in clinical practice contributed to an improvement in key measures of disease activity."
09/01/2004 - "Results of many clinical trials point to hydroxyurea administration for patients with frequent painful crises and acute chest syndrome. "
01/01/2023 - "We are unsure if hydroxyurea improves glomerular filtration rate or reduces hyperfiltration in children aged nine to 18 months, but it may improve their ability to concentrate urine and may make little or no difference to the incidence of acute chest syndrome, painful crises, and hospitalisations. "
01/01/2023 - "Hydroxyurea compared to placebo may improve the ability to concentrate urine (MD 42.23 mOsm/kg, 95% CI 12.14 to 72.32; 178 participants; low certainty), and may make little or no difference to SCD-related serious adverse events, including acute chest syndrome (risk ratio (RR) 0.39, 99% CI 0.13 to 1.16; 193 participants; low certainty), painful crisis (RR 0.68, 99% CI 0.45 to 1.02; 193 participants; low certainty); and hospitalisations (RR 0.83, 99% CI 0.68 to 1.01; 193 participants; low certainty). "
2. Anti-Bacterial Agents (Antibiotics)IBA
01/01/2019 - "To determine whether an empirical antibiotic treatment approach (used alone or in combination):1. is effective for acute chest syndrome compared to placebo or standard treatment;2. is safe for acute chest syndrome compared to placebo or standard treatment;Further objectives are to determine whether there are important variations in efficacy and safety:3. for different treatment regimens,4. by participant age, or geographical location of the clinical trials. "
03/06/2015 - "To determine whether an empirical antibiotic treatment approach (used alone or in combination):1. is effective for acute chest syndrome compared to placebo or standard treatment;2. is safe for acute chest syndrome compared to placebo or standard treatment;Further objectives are to determine whether there are important variations in efficacy and safety:3. for different treatment regimens,4. by participant age, or geographical location of the clinical trials. "
01/31/2013 - "To determine whether an empirical antibiotic treatment approach (used alone or in combination): 1. is effective for acute chest syndrome compared to placebo or standard treatment; 2. is safe for acute chest syndrome compared to placebo or standard treatment;Further objectives are to determine whether there are important variations in efficacy and safety: 3. for different treatment regimens, 4. by participant age, or geographical location of the clinical trials. "
04/18/2007 - "To determine whether an empirical antibiotic treatment approach (used either alone or in combination): (a) is effective in treating acute chest syndrome compared to placebo or standard treatment; (b) is safe in treating acute chest syndrome compared to placebo or standard treatment; (c) differs dependent on the regimen used in treating acute chest syndrome differ from each other with respect to efficacy and safety; and (d) varies between different age groups, regions or countries with respect to efficacy and safety. "
01/01/2019 - "The clinical presentation of acute chest syndrome is similar whether due to infectious or non-infectious causes, thus antibiotics are usually prescribed to treat all episodes. "
3. Bronchodilator Agents (Bronchodilators)IBA
4. Nitric Oxide (Nitrogen Monoxide)FDA Link
5. Arginine (L-Arginine)FDA Link
6. Oxygen (Dioxygen)IBA
7. Narcotics (Narcotic Analgesics)IBA
8. Glutamine (L-Glutamine)FDA Link
9. crizanlizumabIBA
10. Heme Oxygenase-1IBA

Therapies and Procedures

1. Therapeutics
2. Blood Transfusion (Blood Transfusions)
3. Extracorporeal Membrane Oxygenation
4. Noninvasive Ventilation
5. Analgesia
08/01/2017 - "Timely, appropriate, and sufficient analgesia is critical, especially when patients experience a vaso-occlusive crisis, acute chest syndrome, or acute postoperative pain. "
01/01/2014 - "All patients were followed regarding the post-operative analgesia and the incidence of post-operative SCD related complications (acute chest syndrome, painful crisis and cerebrovascular accident). "
06/01/2016 - "Following admission for a typical pain crisis, the patient continued to report unrelieved pain with marked agitation for several days, despite escalating doses of opioid analgesia, and ultimately required intubation following development of acute chest syndrome (ACS). "
08/01/2022 - "Management of the acute chest syndrome should be prompt and implies, besides the recognition of severity signs, a multimodal analgesia, oxygen supplementation, sometimes a parenteral antibiotic treatment and the frequent use of blood transfusions especially in the most severe cases. "
01/01/2023 - "Diagnosis is made through physical exam, blood work, and chest imaging.1,2 Chest radiograph is considered the gold standard for imaging modality.3 Management of acute chest syndrome includes hydration with IV crystalloid solutions, antibiotics, judicious analgesia, oxygen, and, in severe cases, transfusion.6 Emergency medicine practitioners should keep acute chest syndrome as a cannot miss, high consequence differential diagnosis for all patients with sickle cell disease presenting to the Emergency Department. "