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Acute Chest Syndrome — Prepare for Exchange Transfusion

Prepare for exchange transfusion in the PICU if pt. presents with severe or rapidly progressing ACS or Hgb>10 gm/dL: 

  • Alert PICU and pheresis team
  • Automated RBC exchange preferred
  • Labs after apheresis: CBC, retic, and HbS
  • Goal: HbS level <30%, Hgb 10 - 11 gm/dL



These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.