Episodes of acute chest syndrome may be precipitated by a number of triggers.

Precipitating factors may include:

(1) infection (bacterial, atypical agents, virus, asplenia)

(2) pulmonary vascular occlusion (venous thromboembolism, fat embolism, in situ thrombosis)

(3) hypoventilation/hypoxia (abdominal pain, thoracic bony infarction, opioids, over-sedation)

(4) pulmonary edema (fluid overload, opioids, pulmonary vascular injury)

(5) bronchospasm/asthma


Surgery and the post-operative state may involve several of these factors (hypoventilation, sedation, opioids, fluid overload).

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