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Anaesthesia for peculiar cells'a century of sickle cell disease

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1 Anaesthesia for peculiar cells'a century of sickle cell disease
P.G. Firth  British Journal of Anaesthesia  Volume 95, Issue 3, Pages (September 2005) DOI: /bja/aei129 Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

2 Fig 1 The anaesthetic ‘vicious cycle’ hypothesis suggests that any condition that leads to increased sickling causes venous sludging, exacerbating sickling and creating a vicious cycle of further flow impairment, hypoxia, sickling, stasis, ischaemia, and infarction. British Journal of Anaesthesia  , DOI: ( /bja/aei129) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

3 Fig 2 The ‘vascular inflammation’ hypothesis suggests that vaso-occlusion is triggered and propagated largely by alterations in the chronically disrupted cellular, plasma, and vascular components of haemostasis, rather than by fluctuations in sickling. Sickle cell disease causes chronic vascular inflammation, and triggers such as surgical stress produce pathological haemostatic responses. Abbreviations: A = adenine, G = guanine, T = thymine, IL-1, IL-6 = interleukin 1 and 6, TNF = tumour necrosis factor. British Journal of Anaesthesia  , DOI: ( /bja/aei129) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions


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