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7, 8 Additionally, patients with SCD tend to reduce their intake during a period of illness and especially during severe pain.

Renal concentrating defects as a result of continuous haemolytic and vaso-occlusive damage of the renal medulla render patients with SCD susceptible to hypovolaemia and dehydration. Patients with SCD are particularly prone to dehydration due to multiple factors. Intake of ample fluids or administration of IV fluids is by many perceived as an important part of VOC treatment, as a decrease in body fluid levels is thought to promote and sustain the sickling process. 6 Besides treatment of a potential underlying cause, extra fluids, (opioid) analgesics, and occasionally oxygen support are part of the treatment of VOC. 2- 5 Despite the improvements made in our understanding of the pathophysiology of VOC, its treatment still primarily consists of supportive care. 1 VOCs account for the vast majority of SCD-related hospital admissions and are associated with significant morbidity and mortality, and negatively impact quality of life. IV-FT is often not adjusted despite a positive history of fluid overload or when top-up transfusion is indicated, emphasising the need for more awareness of this complication and a personalised approach.Īcute painful vaso-occlusive crisis (VOC) is one of the clinical hallmarks of sickle cell disease (SCD). Fluid overload is frequently encountered during IV-FT for VOC. IV-FT was not reduced in 86% of patients despite a previous history of fluid overload. A positive history of fluid overload ( P = 0♰17), lactate dehydrogenase level ( P = 0♰11), and top-up transfusion during admission ( P = 0♰05) were independently associated with fluid overload occurrence. Hospital stay was longer in patients with fluid overload (6♰ vs. Fluid overload occurred in 21% of 100 patients. The median (interquartile range) age was 25♰ (18♳–33♸) years and 65% had a severe genotype (HbSS/HbSβ 0-thal). Consecutive hospitalisations for VOC treated with IV-FT between September 2016 and September 2018 were retrospectively analysed. We aimed to evaluate the incidence and risk factors of fluid overload due to IV-FT in patients with SCD. However, data on the adverse effects of IV-FT for VOC is sparse. Patients with sickle cell disease (SCD) are at risk of developing diastolic dysfunction and fluid overload due to IV-FT. Intravenous fluid therapy (IV-FT) is routinely used in the treatment of vaso-occlusive crises (VOCs), as dehydration possibly promotes and sustains erythrocyte sickling.