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Acute Chest Syndrome: Is the Patient Exhibiting Signs Necessitating PICU Care?

Admission to PICU or Hem/Onc service depends on clinical status. If status indicates a more severe course, a PICU admission is warranted:

  • Multilobar disease without pleural effusion
  • Increased work of breathing rule out impending cardiorespiratory failure
  • Inability to maintain oxygen saturation above 95% even with supplemental oxygen
  • Pleural effusions requiring BiPAP/CPAP for respiratory support
  • Requiring exchange transfusion


These pathways 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 a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.