Fig. 3
From: Vaso-occlusive crisis in sickle cell disease: a vicious cycle of secondary events
A proposed multipronged approach to treating VOC. Instead of just using intravenous fluid, oxygen, and pain management and wait for the VOC process to resolve spontaneously, a more proactive approach is proposed using a combination of the listed agents to target as many of the downstream processes as possible. Acute use of antisickling agents such as voxelotor may protect the un-involved erythrocytes from sickling induced by the many downstream events of VOC. On the other hand, approaches that target the downstream events will more likely be successful if used in combination to overcome as many of the downstream pathways as possible