title: Sickle cell disease in the ICU.
abstract: OBJECTIVE
  The review focuses on severe acute vaso-occlusive manifestations of sickle cell disease leading adult patients to the ICU.
  
  
  RESULTS
  Careful consideration should be paid to look for pulmonary vascular dysfunction and acute kidney injury, because of their prognostic role during acute vaso-occlusive manifestations. Alloimmunization and delayed haemolytic transfusion reactions are emerging complications that should be thought to be diagnosed, as they may imply a conservative management. The life-threatening complication raises the question about the indications of blood transfusion therapy for acute sickle cell disease complications, no randomized controlled trials being available to assess the role of blood transfusion in the acute setting.
  
  
  CONCLUSIONS
  Acute vaso-occlusive episodes are characterized by an unpredictable course that needs for vigilance for everyone, and justifies ICU or intermediate care unit admission to allow close monitoring, and supportive treatment in a timely fashion.
authors.affiliation: aService de Réanimation Médicale, Assistance Publique - Hôpitaux de Paris, Groupe Henri Mondor - Albert Chenevier bUniversité Paris Est, Institut Mondor de Recherche Biomédicale - Groupe de Recherche Clinique CARMAS, Créteil cAP-HP, Hôpital Tenon, Unité de Réanimation Médico-Chirurgicale, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien dSorbonne Universités, UPMC Université eCollégium Gallilée, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Cecchini
authors.forename: Muriel
authors.initials: M
authors.lastname: Fartoukh
mesh_terms: D056586:Acute Chest Syndrome / Q000209:etiology / Q000628:therapy; D000755:Anemia, Sickle Cell / Q000150:complications*; D017707:Erythrocyte Transfusion; D006801:Humans; D007362:Intensive Care Units; D009102:Multiple Organ Failure / Q000209:etiology / Q000628:therapy; D011668:Pulmonary Veno-Occlusive Disease / Q000209:etiology / Q000628:therapy; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D065227:Transfusion Reaction / Q000628:therapy; D014652:Vascular Diseases / Q000209:etiology* / Q000628:therapy*