TAILIEUCHUNG - Chapter 099. Disorders of Hemoglobin (Part 8)

Acute chest syndrome is a medical emergency that may require management in an intensive care unit. Hydration should be monitored carefully to avoid the development of pulmonary edema, and oxygen therapy should be especially vigorous for protection of arterial saturation. Diagnostic evaluation for pneumonia and pulmonary embolism should be especially thorough, since these may occur with atypical symptoms. | Chapter 099. Disorders of Hemoglobin Part 8 Acute chest syndrome is a medical emergency that may require management in an intensive care unit. Hydration should be monitored carefully to avoid the development of pulmonary edema and oxygen therapy should be especially vigorous for protection of arterial saturation. Diagnostic evaluation for pneumonia and pulmonary embolism should be especially thorough since these may occur with atypical symptoms. Critical interventions are transfusion to maintain a hematocrit 30 and emergency exchange transfusion if arterial saturation drops to 90 . As patients with sickle cell syndrome increasingly survive into their fifth and sixth decades end-stage renal failure and pulmonary hypertension are becoming increasingly prominent causes of end-stage morbidity. A sickle cell cardiomyopathy and or premature coronary artery disease may compromise cardiac function in later years. Sickle cell patients have received kidney transplants but they often experience an increase in the frequency and severity of crises possibly due to increased infection as a consequence of immunosuppre ssion. The most significant advance in the therapy of sickle cell anemia has been the introduction of hydroxyurea as a mainstay of therapy for patients with severe symptoms. Hydroxyurea 10-30 mg kg per day increases fetal hemoglobin and may also exert beneficial affects on RBC hydration vascular wall adherence and suppression of the granulocyte and reticulocyte counts dosage is titrated to maintain a white cell count between 5000 and 8000 per pL. White cells and reticulocytes may play a major role in the pathogenesis of sickle cell crisis and their suppression may be an important benefit of hydroxyurea therapy. Hydroxyurea should be considered in patients experiencing repeated episodes of acute chest syndrome or with more than three crises per year requiring hospitalization. The utility of this agent for reducing the incidence of other complications priapism .

• Y học thường thức
• Disorders of Hemoglobin
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• BMC Musculoskeletal Disorders
• Intertrochanteric fractures
• Unstable fractures
• Hemoglobin drop
• Perioperative complications
• AO classification
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care
• Total knee arthroplasty
• Sedative hypnotics
• Post operative complications
• Orthopaedic surgery
• Locomotive syndrome risk
• Musculoskeletal organs
• Glycated hemoglobin
• Total protein
• Tranexamic acid
• Intravenous injection
• Topical injection
• Articular cartilage
• Synovial cells
• Thrombospondin motifs
• Aggrecan degradation
• Early stage osteoarthritis