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Titolo:
The role of rib infarcts in the acute chest syndrome of sickle cell diseases
Autore:
Rucknagel, DL;
Indirizzi:
Univ Cincinnati, Coll Med, Cincinnati, OH 45229 USA Univ Cincinnati Cincinnati OH USA 45229 oll Med, Cincinnati, OH 45229 USA Childrens Hosp Med Ctr, Cincinnati Comprehens Sickle Cell Ctr, Cincinnati,OH USA Childrens Hosp Med Ctr Cincinnati OH USA kle Cell Ctr, Cincinnati,OH USA
Titolo Testata:
PEDIATRIC PATHOLOGY & MOLECULAR MEDICINE
fascicolo: 2, volume: 20, anno: 2001,
pagine: 137 - 154
SICI:
1522-7952(200103/04)20:2<137:TRORII>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
NITRIC-OXIDE; FAT-EMBOLISM; PULMONARY-HYPERTENSION; VASCULAR ENDOTHELIUM; S-NITROSOHEMOGLOBIN; OXYGEN-AFFINITY; LUNG-DISEASE; RISK-FACTORS; PAIN CRISIS; ANEMIA;
Keywords:
acute chest syndrome; fat embolism; hypoxia; incentive spirometer; nitric oxide; sickle cell;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
70
Recensione:
Indirizzi per estratti:
Indirizzo: Rucknagel, DL Univ Cincinnati, Coll Med, Cincinnati, OH 45229 USA Univ Cincinnati Cincinnati OH USA 45229 nnati, OH 45229 USA
Citazione:
D.L. Rucknagel, "The role of rib infarcts in the acute chest syndrome of sickle cell diseases", PEDIAT PATH, 20(2), 2001, pp. 137-154

Abstract

The acute chest syndrome is a generic term for pulmonary complications of sickle cell diseases with heterogeneous etiologies that include pneumonia, vaso-occlusion of pulmonary arterioles, rib infarction, and fat embolism syndrome. My review summarizes these etiologies, the evidence, and pathophysiology supporting the hypothesis that infarction of segments of ribs by the same vaso-occlusive process responsible for the acute episodes of pain (characteristic of the sickle cell diseases) is often involved in the acute chest structure. Inflammation associated with the infarct then causes splinting, hypoventilation, and hypoxia and further vaso-occlusion. The relationship with adult respiratory distress syndrome and fat embolism is also discussed. Use of the incentive spirometer combined with effective analgesia when chest pain is present is advocated for prevention of the pulmonary infiltrates. Newer understanding of the role of nitric oxide in regulating oxygen transport and its relationship to blood transfusions used in therapy of the acute chest syndrome are discussed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 15:45:36