Cardiovascular Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.


Journal

Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422

Informations de publication

Date de publication:
01 01 2022
Historique:
accepted: 24 09 2021
entrez: 31 12 2021
pubmed: 1 1 2022
medline: 23 2 2022
Statut: ppublish

Résumé

Cardiovascular dysfunction is associated with poor outcomes in critically ill children. We aim to derive an evidence-informed, consensus-based definition of cardiovascular dysfunction in critically ill children. Electronic searches of PubMed and Embase were conducted from January 1992 to January 2020 using medical subject heading terms and text words to define concepts of cardiovascular dysfunction, pediatric critical illness, and outcomes of interest. Studies were included if they evaluated critically ill children with cardiovascular dysfunction and assessment and/or scoring tools to screen for cardiovascular dysfunction and assessed mortality, functional status, organ-specific, or other patient-centered outcomes. Studies of adults, premature infants (≤36 weeks gestational age), animals, reviews and/or commentaries, case series (sample size ≤10), and non-English-language studies were excluded. Studies of children with cyanotic congenital heart disease or cardiovascular dysfunction after cardiopulmonary bypass were excluded. Data were abstracted from each eligible study into a standard data extraction form, along with risk-of-bias assessment by a task force member. Cardiovascular dysfunction was defined by 9 elements, including 4 which indicate severe cardiovascular dysfunction. Cardiopulmonary arrest (>5 minutes) or mechanical circulatory support independently define severe cardiovascular dysfunction, whereas tachycardia, hypotension, vasoactive-inotropic score, lactate, troponin I, central venous oxygen saturation, and echocardiographic estimation of left ventricular ejection fraction were included in any combination. There was expert agreement (>80%) on the definition. All included studies were observational and many were retrospective. The Pediatric Organ Dysfunction Information Update Mandate panel propose this evidence-informed definition of cardiovascular dysfunction.

Identifiants

pubmed: 34970677
pii: 184284
doi: 10.1542/peds.2021-052888F
pmc: PMC9745438
mid: NIHMS1843069
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

S39-S47

Subventions

Organisme : NINDS NIH HHS
ID : R01 NS106292
Pays : United States

Investigateurs

Michael Agus (M)
Ayse Akcan-Arikan (A)
Rajit Basu (R)
Tellen D Bennett (TD)
Leonardo R Brandão (LR)
Ann-Marie Brown (AM)
Joseph A Carcillo (JA)
Jill Cholette (J)
Ira M Cheifetz (IM)
Timothy Cornell (T)
Allan Doctor (A)
Simon Erickson (S)
Reid W D Farris (RWD)
E Vincent S Faustino (EVS)
Julie C Fitzgerald (JC)
Dana Y Fuhrman (DY)
John S Giuliano (JS)
Kristin Guilliams (K)
Stephen M Gorga (SM)
Mark Hall (M)
Sheila J Hanson (SJ)
Mary Hartman (M)
Amanda B Hassinger (AB)
Sharon Y Irving (SY)
Philippe Jouvet (P)
Sujatha Kannan (S)
Oliver Karam (O)
Robinder G Khemani (RG)
Jacques Lacroix (J)
Francis Leclerc (F)
Jan Hau Lee (JH)
Stephane Leteurtre (S)
Katie Lobner (K)
Patrick J McKiernan (PJ)
Kusum Menon (K)
Paul Monagle (P)
Jennifer A Muszynski (JA)
Folafoluwa Odetola (F)
Robert Parker (R)
Nazima Pathan (N)
Richard W Pierce (RW)
Jose Pineda (J)
Jose M Prince (JM)
Karen A Robinson (KA)
Courtney M Rowan (CM)
L. Nelson Sanchez-Pinto (LN)
Luregn J Schlapbach (LJ)
David T Selewski (DT)
Dennis Simon (D)
Lincoln S Smith (LS)
James E Squires (JE)
Robert H Squires (RH)
Scott M Sutherland (SM)
Yves Ouellette (Y)
Michael C Spaeder (MC)
Vijay Srinivasan (V)
Marie E Steiner (ME)
Robert C Tasker (RC)
Neal Thomas (N)
Pierre Tissieres (P)
Chani Traube (C)
Marisa Tucci (M)
Katri V Typpo (KV)
Mark S Wainwright (MS)
Shan L Ward (SL)
R Scott Watson (RS)
Scott Weiss (S)
Jane Whitney (J)
Doug Willson (D)
James L Wynn (JL)
Nadir Yehya (N)

Informations de copyright

Copyright © 2021 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

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Auteurs

Peta M A Alexander (PMA)

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
Departments of Pediatrics.

Paul A Checchia (PA)

Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.

Lindsay M Ryerson (LM)

Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

Desmond Bohn (D)

Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

Michelle Eckerle (M)

Department of Pediatrics, College of Medicine, University of Cincinnati and Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Michael Gaies (M)

Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.

Peter Laussen (P)

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
Anesthesia, Harvard Medical School, Harvard University, Boston, Massachusetts.

Howard Jeffries (H)

Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington.

Ravi R Thiagarajan (RR)

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
Departments of Pediatrics.

Lara Shekerdemian (L)

Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.

Melania M Bembea (MM)

Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.

Jerry J Zimmerman (JJ)

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital and Harborview Medical Center and School of Medicine, University of Washington, Seattle, Washington.

Niranjan Kissoon (N)

Division of Critical Care, Department of Pediatrics, The University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada.

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