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抗凝药物:儿童体外膜氧化抗凝协作共识会议共识会议

Katherine Cashen¹, Arun Saini², Leonardo R Brandão³

¹Division of Critical Care Medicine, Department of Pediatrics, Duke University and Duke University Health System, Durham, NC.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

|July 3, 2024

概括

对于儿科外体膜氧化 (ECMO) 的最佳抗凝剂缺乏足够的证据. 进一步进行高质量的研究对于制定儿童ECMO抗凝药的基于证据的指导方针至关重要.

科学领域:

儿科重症监护医药儿科重症监护医药
支持心肺血管的支持.
药理学药理学是指药理学的学科.

背景情况:

抗凝剂对于儿科外体膜氧化 (ECMO) 非常重要.
目前关于最佳抗凝策略的证据有限.
对于儿科ECMO患者的安全和有效抗凝药,需要标准化指导方针.

研究的目的:

在儿科ECMO中建立基于共识的抗凝剂建议.
通过系统审查和修改的Delphi过程来告知临床实践.
为解决儿童ECMO抗凝药缺乏基于证据的指导方针的问题.

主要方法:

从1988年到2021年,对PubMed,EMBASE和Cochrane图书馆 (CENTRAL) 的系统文献搜索.
修改后的Delphi过程涉及48名专家在两年内.
使用推评估,开发和评估 (GRADE) 和预后研究质量 (QUIPS) 工具进行证据评估.

主要成果:

制定了两个建议,两个共识声明和一个关于儿科ECMO抗凝药的良好实践声明.
在所有开发的陈述上达成>80%的专家一致意见.
确定了儿科ECMO期间抗凝血药物的证据基础中的重大差距.

结论:

没有足够的证据来确定在儿科ECMO期间的最佳抗凝治疗.
高质量的研究是指导基于证据的实践对抗凝血在这个人群中至关重要的.
在没有强有力的证据的情况下,共识声明提供了临时指导.

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