title: [Treatment of a female patient with sickle-cell anemia during cardiac surgery with cardiopulmonary bypass].
abstract: A 17-year-old girl with drepanocytic (sickle-cell) anemia who was being treated with hydroxyurea and periodic blood transfusions through a Hickman-type catheter was admitted for periodic episodes of fever. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. Massive right atrial thrombosis with pulmonary embolism and bacterial endocarditis were detected by computed tomography. Surgery with a beating heart and cardiopulmonary bypass was undertaken. Drepanocytic anemia in individuals homozygous for hemoglobin S is a rare condition in Spain but we are beginning to see a few cases, in which management during anesthesia will be more complicated. High-risk surgery can be carried out in these patients without adverse events if the anesthesiologist is guided by a complete blood workup and takes precautions during and after surgery to control hydration, oxygenation, temperature, and the acid-base balance.
authors: Servicio de Anestesiología y Reanimación, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid. macedo.hcsc@salud.madrid.org
authors: M V Acedo
authors: MV
authors: Díaz-Pache
authors: M V
authors: MV
authors: Sarrión Bravo
authors: J
authors: J
authors: Silva Guisasola
authors: J
authors: J
authors: Ariño Irujo
authors: F
authors: F
authors: López Timoneda
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D002545:Brain Ischemia / Q000628:therapy; D002315:Cardiopulmonary Bypass; D055499:Catheter-Related Infections / Q000150:complications / Q000382:microbiology / Q000601:surgery; D004293:Dominican Republic / Q000208:ethnology; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000601:surgery*; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D006325:Heart Atria / Q000382:microbiology / Q000601:surgery; D006331:Heart Diseases / Q000209:etiology / Q000601:surgery; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D000860:Hypoxia / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control*; D055624:Methicillin-Resistant Staphylococcus aureus; D011229:Preanesthetic Medication; D011655:Pulmonary Embolism / Q000209:etiology; D013030:Spain; D013290:Streptococcal Infections / Q000150:complications / Q000601:surgery; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D014261:Tricuspid Valve / Q000382:microbiology / Q000601:surgery*
chemical_list: D006918:Hydroxyurea