Acute chest syndrome in children with sickle cell disease: Data from a national AIEOP cohort identify priority areas of intervention in a hub‐and‐spoke system

Author:

Munaretto V.1,Corti P.2ORCID,Bertoni E.3,Tripodi S. I.4,Guerzoni M. E.5,Cesaro S.6,Arcioni F.7,Piccolo C.8,Mina T.4,Zecca M.4ORCID,Cuzzubbo D.9,Casale M.10ORCID,Palazzi G.5,Notarangelo L. D.3,Masera N.2,Samperi P.11,Perrotta S.10,Russo G.11ORCID,Sainati L.1,Colombatti R.1ORCID

Affiliation:

1. Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health Azienda Ospedale‐Università di Padova Padova Italy

2. Clinica si Onco‐Ematologia Pediatrica Fondazione MBBM Azienda Ospedaliera S. Gerardo Monza Italy

3. Clinica di Onco‐Ematologia Pediatrica ASS Spedali Civili di Brescia Brescia Italy

4. Pediatric Hematology/Oncology Fondazione IRCCS Policlinico San Matteo Pavia Italy

5. Azienda Ospedaliera‐Università di Modena Modena Italy

6. Pediatric Hematology‐Oncology Ospedale della Donna e del Bambino Verona Italy

7. Clinica di Oncoematologia Pediatrica Ospedale Santa Maria della Misericordia Perugia Italy

8. Clinica di Onco‐Ematologia Pediatrica Ospedale del Ponte Varese Italy

9. Clinica di Onco‐EmatologiaPediatrica Azienda Ospedaliero Universitaria Meyer Florence Italy

10. Università degli studi della Campania Luigi Vanvitelli Naples Italy

11. Pediatric Hematology/Oncology Unit, Azienda Policlinico‐Vittorio Emanuele University of Catania Catania Italy

Abstract

SummaryAcute chest syndrome (ACS) is a frequent cause of hospitalization in sickle cell disease (SCD). Despite advances in acute care, many settings still lack knowledge about ACS best practices. After the AIEOP Guidelines were published in 2012, suggesting standardized management in Italy, a retrospective study was performed to assess the diagnostic and therapeutic pathways of ACS in children. From 2013 to 2018, 208 ACS episodes were presented by 122/583 kids in 11 centres. 73 were male, mean age 10.9 years, 85% African, 92% HbSS or Sβ°. In our hub‐and‐spoke system, a good adherence to Guidelines was documented, but discrepancies between reference centres and general hospitals were noted. Improvement is needed for timely transfer to reference centres, use of incentive spirometry, oxygen therapy and pain management.

Funder

Fondazione Città della Speranza

Publisher

Wiley

Subject

Hematology

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