Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.
Journal
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
ISSN: 1529-7535
Titre abrégé: Pediatr Crit Care Med
Pays: United States
ID NLM: 100954653
Informations de publication
Date de publication:
01 Jul 2024
01 Jul 2024
Historique:
medline:
3
7
2024
pubmed:
3
7
2024
entrez:
3
7
2024
Statut:
ppublish
Résumé
To derive systematic-review informed, modified Delphi consensus regarding the management of bleeding and thrombotic complications during pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE Consensus Conference. A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021. The management of bleeding and thrombotic complications of ECMO. Two authors reviewed all citations independently, with a third independent reviewer resolving conflicts. Twelve references were used for data extraction and informed recommendations. Evidence tables were constructed using a standardized data extraction form. Risk of bias was assessed using the Quality in Prognosis Studies tool. The evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Forty-eight experts met over 2 years to develop evidence-based recommendations and, when evidence was lacking, expert-based consensus statements for the management of bleeding and thrombotic complications in pediatric ECMO patients. A web-based modified Delphi process was used to build consensus via the Research And Development/University of California Appropriateness Method. Consensus was defined as greater than 80% agreement. Two good practice statements, 5 weak recommendations, and 18 consensus statements are presented. Although bleeding and thrombotic complications during pediatric ECMO remain common, limited definitive data exist to support an evidence-based approach to treating these complications. Research is needed to improve hemostatic management of children supported with ECMO.
Identifiants
pubmed: 38959361
doi: 10.1097/PCC.0000000000003489
pii: 00130478-202407001-00008
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Consensus Development Conference
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e66-e77Investigateurs
Peta M A Alexander
(PMA)
Melania M Bembea
(MM)
Katherine Cashen
(K)
Ira M Cheifetz
(IM)
Heidi J Dalton
(HJ)
Adam S Himebauch
(AS)
Oliver Karam
(O)
Katie M Moynihan
(KM)
Marianne E Nellis
(ME)
Caroline Ozment
(C)
Lakshmi Raman
(L)
Natalie E Rintoul
(NE)
Ahmed S Said
(AS)
Arun Saini
(A)
Marie E Steiner
(ME)
Ravi R Thiagarajan
(RR)
Kevin Watt
(K)
Ariane Willems
(A)
Nicole D Zantek
(ND)
Ryan P Barbaro
(RP)
Katherine Steffen
(K)
Adam M Vogel
(AM)
Christopher Almond
(C)
Marc M Anders
(MM)
Gail Annich
(G)
Leonardo R Brandão
(LR)
Wayne Chandler
(W)
Megan Delaney
(M)
Robert DiGeronimo
(R)
Sitaram Emani
(S)
Samir K Gadepalli
(SK)
Alejandro V Garcia
(AV)
Bereketeab Haileselassie
(B)
Adam S Himebauch
(AS)
Robert Hyslop
(R)
Martin C J Kneyber
(MCJ)
Lisa Baumann Kreuziger
(L)
Jennifer Le
(J)
Laura Loftis
(L)
Ali B V McMichael
(ABV)
D Michael McMullan
(D)
Paul Monagle
(P)
Kathleen Nico
(K)
Matthew L Paden
(ML)
Jason Patregnani
(J)
John R Priest
(JR)
Leslie Raffini
(L)
Lindsay M Ryerson
(LM)
Steven R Sloan
(SR)
Jun Teruya
(J)
Andrew R Yates
(AR)
Alison Gehred
(A)
Elizabeth Lyman
(E)
Jennifer A Muszynski
(JA)
Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Déclaration de conflit d'intérêts
The Executive Committee (Drs. Alexander, Muszynski, Bembea, Cheifetz, Steiner, and Barbaro) served as arbitrators for conflict-of-interest management. Dr. Alexander’s institution received funding from Novartis (Prospective Trial to Assess the Angiotensin Receptor Blocker Neprilysin Inhibitor LCZ696 Versus Angiotensin-Converting Enzyme Inhibitor for the Medical Treatment of Pediatric HF [PANORAMA-HF]). Dr. Patregnani discloses consultation payments from MNK Pharmaceuticals and Pfizer. Dr. Bembea’s institution received funding from the National Institute of Neurologic Disorder and Stroke (R01NS106292), the Grifols Investigator Sponsored Research Grant, and the Department of Defense. Drs. Bembea, Alexander, and Muszynski received support for article research from the National Institutes of Health (NIH). Dr. Patregnani received funding from Mallinckrodt Pharmaceutical. Drs. Alexander and Muszynski’s institutions received funding from the NIH. Dr. Alexander’s institution received funding from the Extracorporeal Life Support Organization and Novartis. Dr. Cheifetz received funding from UptoDate. The remaining authors have disclosed that they do not have any potential conflicts of interest.
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