Purnell Marcy C, Rayborn Michong
School of Leadership and Advanced Nursing Practice The University of Southern Mississippi Hattiesburg Mississippi.
EJHaem. 2020 May 6;1(1):230-234. doi: 10.1002/jha2.9. eCollection 2020 Jul.
Sickle cell disease and sickle cell trait affect over 300 million people worldwide. Vaso-occlusive crises (VOCs) are the most common reason that these patients seek medical care.
Recently, a newly identified "trigger" (involving glucose and electrolytes) for a mechanism of abnormal actin polymerization may offer further understanding with regard to the sequence of events that cascade to complications such as VOCs in those with sickle cell disease (SCD) and as well as those with sickle cell trait.
A literature review to identify the current standard of care guidelines for hydration and nutritional strategies during VOCs in patients with SCD and sickle cell trait was conducted in PubMed, OVID, and Google Scholar.
This review suggested that current rationales for hydration and nutritional strategies for these patients during periods of crisis are generally based on consensus and have remained largely undefined to date.
This new trigger, along with this literature review, suggests investigations related to serum glucose and cation (electrolyte) levels may help define novel strategies for the development of protocols/standard of care with regard to intravenous and oral hydration/nutritional guidelines in these patients during both clinical and perioperative management periods.
镰状细胞病和镰状细胞性状影响着全球超过3亿人。血管闭塞性危机（VOCs）是这些患者寻求医疗护理的最常见原因。
最近，一种新发现的异常肌动蛋白聚合机制的“触发因素”（涉及葡萄糖和电解质）可能有助于进一步了解镰状细胞病（SCD）患者以及镰状细胞性状患者中引发诸如VOCs等并发症的一系列事件。
在PubMed、OVID和谷歌学术上进行文献综述，以确定SCD和镰状细胞性状患者发生VOCs时水合作用和营养策略的当前护理标准指南。
该综述表明，目前关于这些患者在危机期间水合作用和营养策略的基本原理通常基于共识，并且迄今为止在很大程度上仍未明确。
这一新的触发因素以及该文献综述表明，与血清葡萄糖和阳离子（电解质）水平相关的研究可能有助于确定在临床和围手术期管理期间针对这些患者制定静脉和口服水合作用/营养指南的方案/护理标准的新策略。
