Table 2 Standard of care guidelines

Intravenous fluids

Maintain adequate hydration with hypotonic crystalloids.

Antibiotics

Treat pathogens responsible for community acquired pneumonia, including “atypicals” or, if necessary, provide a broader spectrum of coverage against antimicrobial organisms.

Supplemental oxygen

Maintain arterial oxygen saturation greater than or equal to 95%.

Analgesia

Maintain adequate analgesia with specifics regarding pain management individualized according to each patient’s established plan of care as dictated by his or her outpatient hematologist.

Red blood cell transfusion

Administered as standard clinical practice in acute chest syndrome with the goal of preventing progression to acute respiratory failure.

Exchange transfusion

Recommended if extensive bilateral pulmonary disease is present, hypoxemia is not corrected with supplemental oxygen, or rapid clinical deterioration occurs.