Surgical procedures are associated with significant sickle-related complications. The NHLBI guidelines provide presurgical transfusion recommendations. ASH has also developed guidelines for transfusion support in patients with SCD. In summary, patients with SCD should be transfused to a hemoglobin level of 9-10 g/dL before surgery.
Not every patient with acute chest syndrome requires transfusion. A patient without significantly worsening anemia and little to no supplemental oxygen requirement requires very close monitoring but may not require a transfusion.
Neither priapism nor asymptomatic worsening of anemia during vaso-occlusive crisis are indications for transfusion.
Simple transfusion for anemia is recommended if hemoglobin drops by at least 2 g/dL from the patient's baseline hemoglobin and the patient is symptomatic.
Learn more about other clinical considerations in SCD.
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Cite this: Sophie M. Lanzkron. Fast Five Quiz: Sickle Cell Disease Presentation and Diagnosis - Medscape - Sep 24, 2021.