Outcome of intensive care management of acute chest syndrome in a Nigerian Teaching Hospital: A preliminary report

Abstract

Objectives: Acute chest syndrome (ACS) is a common complication of vaso-occlusive crisis in sickle cell disease patients. It causes respiratory failure which may require mechanical ventilation in the intensive care unit, but outcome of such intervention has been sparingly reported in our environment. This study highlights the intensive care management and outcomes of acute chest syndrome in our centre.

Design: This was a retrospective descriptive study Setting: This study was carried out at the intensive care unit of a tertiary hospital in Nigeria Subjects or participants: These were 27 sickle cell disease patients with acute chest syndrome managed in our intensive care unit from January 2013 to December 2017.

Methods: We reviewed the medical records of all the 27 sickle cell disease patients managed in our intensive care unit on account of acute chest syndrome in the last 5 years. Relevant information on supplemental oxygen administration, modes of ventilation, transfusion, length of stay in the ICU and mortality rate was also extracted.

Main outcome measure: The main outcome measure was the number of patients who survived and discharged from the intensive care unit.

Results: Nine (50%) out of the 18 patients with acute chest syndrome, complicated by severe respiratory insufficiency, ventilated mechanically survived. The median length of ICU stay was 6 (12) days.

Conclusion: Mechanical ventilation of patients and adequate pain control can help reduce the mortality and enhance the quality of life of sickle cell disease patients with acute chest syndrome.