Safe surgery in sickle cell disease

Banerjee, Anjan K.; Layton, D. M.; Rennie, John; Bellingham, A. J.

doi:10.1002/bjs.1800780503

Cited by 23 publications

(17 citation statements)

References 8 publications

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“…Techniques of transfusion have included acute transfusion, repeated transfusion, and partial exchange transfusion either immediately [9] or 10-15 days prior to surgery [2]. Although most authors recommend aggressive preoperative exchange transfusion to reduce the HbS level [19,21], simple transfusion to increase the hemoglobin level to -> 10 g/dl, independent of hemoglobin S percentage, appears to be appropriate for patients undergoing an elective LC under general anesthesia [1,20].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy in adults with sickle cell disease

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy in adults with sickle cell disease

et al. 2001

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“…Preoperative screening to identify individuals affected with sickle cell disease is recommended as a method to decrease perioperative morbidity in populations at risk for having this hemoglobinopathy. [4][5][6] However, routine preoperative screening of apparently healthy patients for sickle cell disease is controversial. 7,8 The reasons are multiple, and include a lack of data demonstrating that screening has had any impact on perioperative morbidity and mortality, evidence that self-reported ethnicity is inaccurate, increasing proportions of mixed race populations, uncertainty about the reason for screening and whom to screen, and concerns that the preoperative period is an ineffective time for widespread population screening.…”

Section: Discussionmentioning

confidence: 99%

“…4 Without newborn screening, the most common age at diagnosis is one to three years and 80 to 96% of children have been diagnosed by the age of ten years due to some complication. 19 The risk of a well-conducted general anesthetic in the asymptomatic child with undiagnosed sickle cell disease is unknown, but it is probably low, particularly if every patient is considered to be at risk for sickle cell disease and factors that precipitate erythrocyte sickling are avoided.…”

Section: Discussionmentioning

confidence: 99%

Preoperative screening for sickle cell disease in children: clinical implications

Crawford

Galton

Abdelhaleem

2005

Can J Anesth/J Can Anesth

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Purpose: Preoperative screening of at-risk patients for sickle cell disease (SCD) is recommended as a method to decrease perioperative morbidity. However, the effectiveness of preoperative screening in accomplishing this goal has never been demonstrated. We undertook a retrospective study to determine the prevalence of positive test results among those screened preoperatively at our institution and to determine whether amendments to present screening guidelines can be recommended. Methods:The hematology laboratory database of a university teaching hospital was searched to identify all patients who underwent preoperative screening for SCD from October 1999 to October 2003. The medical records of those patients testing positive were reviewed.Results: Of 1,906 children screened preoperatively, 79 (4.1%) were diagnosed as having sickle cell trait and three (0.16%) as having some form of SCD: one had homozygous hemoglobin S and two had sickle-hemoglobin C disease. Two of the three had a family history for SCD and none had a preoperative hemoglobin concentration < 10 g·dL -1. No patient developed perioperative sickle-related complications. Conclusion:Preoperative screening of 1,906 children identified only one asymptomatic child with undiagnosed SCD and a negative family history, suggesting that routine preoperative screening for SCD is rarely of significant clinical value in our population. Had preoperative screening not been performed, no child requiring preoperative transfusion would have been missed, representing a long-run probability of at least 99.84% that no at-risk child would require transfusion. We recommend that preoperative screening for SCD be undertaken selectively, giving consideration to the risks and benefits of screening to the individual patient. Objectif

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“…Patients with SCD are at risk for perioperative complications including ACS, renal failure, pain episodes, and stroke. Preoperative transfusions have been reported beneficial and are usually, but certainly not universally, recommended if the patient is to receive general anesthesia or is to have surgery on the posterior segment of the eye (23,40–57). The optimal transfusion regimen, however, remains controversial.…”

Section: Surgerymentioning

confidence: 99%

The Role of Red Blood Cell Exchange Transfusion in the Treatment and Prevention of Complications of Sickle Cell Disease

Danielson

2002

Therapeutic Apheresis

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Patients with sickle cell disease have abnormal red blood cells (RBCs). This can cause chronic hemolytic anemia and vaso‐occlusion leading to tissue hypoxemia and organ dysfunction. RBC exchange transfusion can, without increasing the whole‐blood viscosity, quickly replace abnormal erythrocytes with normal and raise the hematocrit resulting in improved delivery of oxygen to hypoxic tissues. Unfortunately, transfusion can also be associated with complications. This paper reviews the role of transfusion, both simple and exchange, in the treatment and prevention of sickle‐related complications. The benefits of exchange versus simple transfusion and transfusion versus alternative therapies are discussed.

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Safe surgery in sickle cell disease

Cited by 23 publications

References 8 publications

Laparoscopic cholecystectomy in adults with sickle cell disease

Laparoscopic cholecystectomy in adults with sickle cell disease

Preoperative screening for sickle cell disease in children: clinical implications

The Role of Red Blood Cell Exchange Transfusion in the Treatment and Prevention of Complications of Sickle Cell Disease

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