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- Pathophysiology of SCD is complex, VOC, inflammation, endothelial dysfunction, clotting etc. Treatment should address all aspects of pathophysiology
- All pain in SCD is not SCD VOC pain – they can get other medical complications plus complications of treatment of SCD
- There is no lab marker to prove/disprove VOC
- Think about withdrawal when pt w SCD presents with pain. Use objective measures (COWS)
- Preferred fluid hydration for VOC is hypotonic to achieve intracellular hydration rather than NS which expands plasma volume
- Psychosocial overlay occurs in patients with recurrent pain syndromes over time but should not deter empathetic/compassionate care and treatment
- Multi-disciplinary integrated approach is important esp for transition age population to prevent mortality and morbidity.
