Back to Course

Evidenced Based Management: A Journey for Physicians

0% Complete
0/0 Steps
  1. Historical Perspective, Epidemiology, and Methodology
  2. Overview of the SCD guidelines and chapters
  3. Process and methodology
  4. Consensus Statements
  5. Clinical Practice Guidelines and the institute of Medicine
  6. Prevention of invasive infection
  7. Screening for Renal Disease
  8. Electrocardiogram Screening
  9. Screening for hypertension
  10. Screening for Retinopathy
  11. Screening for risk of stroke using neuroimaging
  12. Screening for Pulmonary disease
  13. Reproductive counseling
  14. Contraception
  15. Clinical Preventive services
  16. Immunizations
  17. Vaso-Occlusive Crisis
  18. Fever
  19. Acute Renal Failure
  20. Priapism
  21. Hepatobiliary Complications
  22. Acute Anemia
  23. Splenic Sequestration
  24. Acute Chest Syndrome
  25. Acute Stroke
  26. Multisystem Organ Failure
  27. Acute Ocular Conditions
  28. Chronic pain
  29. Avascular Necrosis
  30. Leg Ulcers
  31. Pulmonary Hypertension
  32. Renal Complications
  33. Stuttering/Recurrent Priapism
  34. Ophthalmologic Complications
  35. Summary of the Evidence
  36. Hydroxurea Treatment Recommendations
  37. Consensus Treatment Protocol and Technical remarks for the implementation of Hydroxyurea Therapy
  38. Indications for transfusions
  39. Recommendations for Acute and Chronic Transfusion Therapy
  40. Appropriate Management/ Monitoring
  41. Consensus Protocol for Monitoring Individuals on Chronic Transfusion Therapy
  42. Complications of Transfusions
  43. Recommendations for the Management and Prevention of Transfusion Complications
  44. New Research is Needed
  45. Data Systems That Meet the Highest Standards of Scientific Rigor Can Be Invaluable
  46. Improved Phenotyping is needed
  47. Broad collaborations for Research and Care
  48. Beyond Efficacy
  49. Look, Listen, Empathize and Ask
Lesson 26 of 49
In Progress

Multisystem Organ Failure

SCFA_Coach September 25, 2023

Multisystem organ failure (MSOF) is a severe and life-threatening complication usually associated with a VOC and characterized by failure of the lungs, liver, and/or kidneys. MSOF may occur after several days of hospitalization and treatment for a severe VOC, often when pain is beginning to improve. In most cases, patients do not have a history of chronic organ failure. Deterioration is rapid and unexpected. It is usually associated with fever, a rapid decline in hemoglobin concentration and platelet count, and nonfocal encephalopathy. Acute respiratory failure is usually associated with development of ACS. Hepatic failure is associated with marked elevations in total and direct bilirubin, liver enzymes, and blood coagulation screening tests. Acute renal failure is associated with a rapid elevation of serum creatinine, with or without the presence of oliguria and hyperkalemia. Rapid diagnosis and treatment of MSOF is necessary to prevent death.

Summary of the Evidence
An adequate systematic review of the literature with fair sensitivity and specificity for all studies indexed by SCD terms and “multisystem organ failure” was not feasible. No systematic review was conducted, and the panel used a consensus process to develop a proposed strategy for triaging and promptly managing MSOF.


In people with SCD who exhibit severe deterioration during a VOC, immediately evaluate for potential MSOF.
(Consensus-Panel Expertise)
In people with SCD and respiratory failure, support respiratory status with supplemental oxygenation and mechanical ventilation when needed.
(Consensus-Panel Expertise)
Use renal replacement therapy (e.g., hemodialysis) when needed for acute renal failure.
(Consensus-Panel Expertise)
In people with SCD and MSOF, immediately initiate either simple or exchange transfusion in consultation with a sickle cell expert or hematologist.
(Consensus-Panel Expertise)


Your email address will not be published. Required fields are marked *