We report the case of an 8-year-old @entity3458 @entity1 admitted for @entity1576 complicating @entity5837 . Because of threatening @entity1576 , tracheal intubation was performed immediately after ICU admission. The @entity1 met the criteria for @entity649 with a PaO2/FiO2 ratio of 94mmHg. An exchange transfusion was performed immediately after admission. HbS fraction failed from 69  % to 30  %. Fluid resuscitation with crystalloids and continuous @entity1063 infusion was needed because of arterial @entity551 . Due to persistent severe @entity519 with PaO2/FiO2 ratio below 100, the @entity1 was placed in prone positioning 16hours after admission, for a total duration of 14hours. A second 12-hour session of prone positioning was performed 41h after admission and PaO2/FiO2 ratio reached 300mmHg after. Treatment also included transfusion of two red-cell pack on day 1 and 2 after admission in order to maintain hemoglobin level above 8g/dL, and a daily @entity1501 supplementation. The control of @entity221 was achieved by a systematic parenteral administration of @entity1443 . @entity3524 and @entity68592 were continued until day 7 despite the negative results of all bacteriological samples. The outcome was favorable from day 3 and the @entity1 met the criteria for extubation on day 5. A first attempt of extubation was performed on day 5, but re-intubation was required because of @entity4 . Steroids were given for 48h and the @entity1 was successfully extubated on day 7. She was discharged from the ICU on day 8, and from the hospital on day 12. We discuss the various treatments available for the management of @entity5837 and their actual relevance in acute @entity649 in the absence of strong evidence-based guidelines in pediatric @entity649 .

[Acute @entity649 complicating an XXXX : Potential benefit of early combination of exchange transfusion and prone positioning].

@entity1 :: ('9606', 'Species') :: ['patient', 'child'] @entity1501 :: ('MESH:D005492', 'Chemical') :: ['folic acid'] @entity649 :: ('MESH:D012128', 'Disease') :: ['ARDS', 'respiratory distress syndrome'] @entity4 :: ('MESH:D004487', 'Disease') :: ['laryngeal edema'] @entity3458 :: ('MESH:D000755', 'Disease') :: ['sickle cell anemia'] @entity5837 :: ('MESH:D056586', 'Disease') :: ['acute chest syndrome'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity3524 :: ('MESH:D002439', 'Chemical') :: ['Cefotaxime'] @entity519 :: ('MESH:D000860', 'Disease') :: ['hypoxemia'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure', 'acute respiratory failure'] @entity68592 :: ('MESH:C058417', 'Chemical') :: ['erythromycine'] @entity1443 :: ('MESH:D000082', 'Chemical') :: ['paracetamol'] @entity1063 :: ('MESH:D009638', 'Chemical') :: ['norepinephrine'] @entity221 :: ('MESH:D005334', 'Disease') :: ['hyperthermia']
@entity5837 :: (MESH:D056586,Disease) :: ['acute chest syndrome']
