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Abstract：
Red cell exchanges (RCE) help in the treatment of complications of sickle cell anemia (SCA) by reducing the viscosity of blood and improving the oxygen-carrying capacity. We present a case of sickle cell crisis (SCC) managed with automated RCE and also reviewed the literature to assess the utilization and clinical efficiency of this therapy in India. A 19-year-old gentleman diagnosed with SCA presented with acute chest syndrome. Hemoglobin (Hb) was 8.8 g%, hematocrit (HCT) was 24%, and HbS was 90%. As there was worsening of symptoms with conventional management, the patient underwent two procedures of automated RCE. The clinical condition of the patient was improved, HbS was reduced to 16% and HCT was remained at 21% postprocedure. Articles on automated RCE in SCA conducted in India were reviewed and four articles were analyzed based on the search strategy. All the included articles concluded automated RCE as an effective procedure for complications of SCA. Common indication in India was SCA patients undergoing surgery as a prophylactic measure. Automated RCEs are promising as an acute treatment for indicated sickle cell complications. This therapy is underutilized in the Indian scenario, especially in patients with SCC.
摘要：
红细胞交换（RCE）通过降低血液粘度和改善携氧能力来帮助治疗镰状细胞性贫血（SCA）的并发症。我们介绍了使用自动RCE管理的镰状细胞危象（SCC）病例，并回顾了文献以评估该疗法在印度的利用率和临床效率。一位19岁的绅士被诊断为SCA，并表现为急性胸部综合症。血红蛋白（Hb）为8.8g％，血细胞比容（HCT）为24%，HbS为90%。由于常规治疗的症状恶化，患者接受了两个自动RCE程序。患者的临床状况有所改善，术后HbS降至16%，HCT保持在21%。回顾了在印度进行的有关SCA中自动RCE的文章，并根据搜索策略对四篇文章进行了分析。所有纳入的文章都认为自动RCE是治疗SCA并发症的有效方法。在印度，常见的适应症是接受手术作为预防措施的SCA患者。自动化RCEs有望作为指示镰状细胞并发症的急性治疗方法。这种疗法在印度的情况下没有得到充分利用，尤其是SCC患者。
