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Does Splinting From Thoracic Bone Ischemia and Infarction Contribute to the Acute Chest Syndrome in Sickle Cell Disease?

Steve H. Salzman, MD, FCCP
Author and Funding Information

Affiliations: New York, NY
 ,  Dr. Salzman is Director, Pulmonary Function Laboratory, Beth Israel Medical Center, and Associate Professor of Clinical Medicine, Albert Einstein College of Medicine.

Correspondence to: Steve H. Salzman, MD, FCCP, Beth Israel Medical Center, Pulmonary and Critical Care Medicine, 7D83, First Ave at 16th St, New York, NY 10003; e-mail: ssalzman@bethisraelny.org



Chest. 2002;122(1):6-9. doi:10.1378/chest.122.1.6
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Research into and treatment of sickle cell disease (SSD) have been the province largely of hematologists and pediatricians. With the realization that pulmonary complications, both acute and chronic, are major causes of morbidity and mortality in patients with this disorder, pulmonary and critical care specialists who treat adults have begun to focus on this disease as well. Mortality rates for patients with sickle cell anemia have declined, with the median age at death being 42 years for men and 48 years for women.1 Factors leading to increased survival into adulthood include penicillin prophylaxis, Haemophilus influenzae and Streptococcus pneumoniae vaccinations, widespread use of newborn screening programs for early detection, and improvements in parental education.,13 In the Cooperative Study of Sickle Cell Disease, acute chest syndrome (ACS) was the second most common complication, exceeded only by painful vaso- occlusive crisis (VOC), and was the most common condition at the time of death.1,46

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