执行总结:儿童体外膜氧化抗凝协作 (PEACE) 协商一致会议
Peta M A Alexander1, Melania M Bembea2, Katherine Cashen3
1Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA.
概括
这项研究提供了91个共识陈述,用于管理儿科外体膜氧化 (ECMO) 患者的抗凝血治疗. 这些基于证据的指导方针旨在规范护理,并为ECMO的重症儿童未来的临床试验提供信息.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心血管外科心血管外科
- 血液学 血液学 血液学
背景情况:
- 身体外膜氧化 (ECMO) 是一种为患有心肺衰竭的重症儿童提供生命支持的技术.
- 优化抗凝管理对于ECMO疗效和患者安全至关重要,但临床实践各不相同.
- 儿科ECMO抗凝血协作 (PEACE) 倡议旨在制定标准化指南.
研究的目的:
- 为儿科ECMO患者的抗凝血药物临床管理制定基于证据的建议和共识陈述.
- 为抗凝固护理提供一个全面的框架,解决一般管理,术后考虑,以及出血/血栓事件.
- 确定儿科ECMO抗凝药的知识差距和研究重点.
主要方法:
- 从1988年到2021年,主要数据库 (PubMed,Embase,Cochrane图书馆) 进行了系统的文献审查.
- 国际,跨专业专家通过连续会议召开会议,以制定声明.
- 通过研究和开发/UCLA适当性方法达成共识,结果根据GRADE系统进行分级.
主要成果:
- 总共制定了91份声明:23份建议,52份专家共识声明和16份良好实践声明.
- 这些声明涵盖一般护理,监测,术后管理和非手术性出血或血栓形成.
- 还确定了三个以研究为重点的良好实践陈述,突出了未来调查的领域.
结论:
- 91个共识声明为在儿科ECMO中标准化抗凝管理提供了基础.
- 这些指南旨在改善临床护理,并作为未来临床试验的基础.
- 和平倡议解决了抗凝血药的关键方面,旨在提高儿童在ECMO上的成果.
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