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Volume 360:1044-1045 March 5, 2009 Number 10
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Pulmonary Complications of Sickle Cell Disease

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by Gladwin, M. T.
To the Editor: In their review, Gladwin and Vichinsky (Nov. 20 issue)1 list events that can precipitate acute pulmonary complications of sickle cell disease, but the inflammatory response after surgical procedures was not discussed. The very high incidence of postoperative complications in sickle cell disease has been assumed to be due to increased sickling.2 However, limited data from humans exposed to severe acute and chronic hypoxia suggest that increased sickling does not invariably trigger vaso-occlusion.3,4 No dose effect of the dilution or removal of sickle erythrocytes by means of aggressive transfusion was detected in one large study.2 In the postoperative . . . [Full Text of this Article]



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