Exchange red blood cell pheresis in a pediatric patient with severe complications of sickle cell anemia.
Exchange transfusion is a well-established procedure for the treatment of severe complications of sickle cell anemia. However, large-volume exchange is a difficult, time-consuming technique, and therefore rarely used. Exchange red blood cell pheresis, using automated equipment, can accomplish red blood cell exchange more rapidly and efficiently, and can be easily performed by a skilled team of nursing personnel. The recent introduction of a pediatric centrifuge bowl allows this technique to be applied to pediatric patients. This procedure was used in a 13-year-old male with sickle cell anemia, who presented with bilateral pulmonary infiltrates, respiratory distress, and hypoxemia, unresponsive to antibiotics and other means of conservative therapy. A one and one-half volume red blood cell exchange reduced the hemoglobin S concentration to 13 per cent. The patient experienced dramatic improvement within 24 hours, progressing to complete recovery within a few days.
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D017707:Erythrocyte Transfusion; D005078:Exchange Transfusion, Whole Blood; D006801:Humans; D008297:Male; D012140:Respiratory Tract Diseases / Q000209:etiology / Q000628:therapy