Document Type

Conference Proceeding

Publication Date

4-2024

Publication Title

ASAIO Journal

Abstract

Abstract Objective: Acute Chest Syndrome (ACS), a life-threatening complication of sickle cell disease (SCD), poses significant challenges in clinical management. The role of Extracorporeal Membrane Oxygenation (ECMO) has been explored in this context with some success. This systematic review aims to comprehensively assess the current literature on the utilization of ECMO in the management of patients with sickle cell disease who develop ACS. Methods: We systematically searched PubMed, Embase, Scopus, and Web of Science for related articles (keywords) to identify relevant studies published up to October 2023. Full-text articles and abstracts were then reviewed for relevance using inclusion and exclusion criteria followed by data extraction. Inclusion criteria encompassed studies reporting on patients with sickle cell disease complicated by ACS (further inclusion criteria) requiring ECMO support. Data extraction focused on patient demographics, ECMO initiation criteria, duration of support, complications, and outcomes. Descriptive statistics were used for analysis. Results: A systematic literature review identified 28 articles meeting inclusion criteria, published between January 1987 and April 2022. These studies collectively involved 25 patients, with 28% of patients placed on veno-arterial (VA) ECMO and 72% on veno-venous (VV) ECMO. The most common reason for extracorporeal support was the development of refractory hypoxia (96%), with an average P/F ratio of 75. The average ECMO run was 14 days. The rate of mortality was 16%. Hgb S was reported in approximately 40% of patients, with an average value of 36% on admission and 12% after initiation of ECMO. Exchange transfusion was performed in 56% of patients. The most common complications were renal failure (20%), pneumothorax (12%), and bloodstream infection (8%). Conclusion: Our systematic review suggests a promising role for ECMO in cases of medically refractory ACS. As the prevalence of SCD continues to rise globally, understanding the role of ECMO in these patients becomes paramount for optimizing clinical outcomes.

Volume

70

Issue

Suppl 2

First Page

23

Comments

40th Annual Children's National Symposium Conference, February 25-28, 2024, Keystone, CO

DOI

10.1097/01.mat.0001011532.79461.0f

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