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Extracorporeal support in children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference.
Dalton, Heidi J; Macrae, Duncan J.
Afiliação
  • Dalton HJ; 1Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ. 2Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.
Pediatr Crit Care Med ; 16(5 Suppl 1): S111-7, 2015 Jun.
Article em En | MEDLINE | ID: mdl-26035361
ABSTRACT

OBJECTIVE:

Extracorporeal life support has undergone a revolution in the past several years with the advent of new, miniaturized equipment and success in supporting patients with a variety of illnesses. Most experience has come with the use of extracorporeal membrane oxygenation, a modified form of cardiopulmonary bypass that can support the heart, lungs, and circulation for days to months at a time. To describe the recommendations for the use of extracorporeal membrane oxygenation in children with pediatric acute respiratory distress syndrome based on a review of the literature and expert opinion.

DESIGN:

Consensus conference of experts in pediatric acute lung injury.

METHODS:

A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. The extracorporeal support subgroup comprised two international experts. When published data were lacking, a modified Delphi approach emphasizing strong professional agreement was used.

RESULTS:

The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the topics related to pediatric acute respiratory distress syndrome, 11 of which related to extracorporeal support. All recommendations had agreement, with 10 recommendations (91%) achieving strong agreement. These recommendations included the utilization of extracorporeal support for reversible causes of pediatric acute respiratory distress syndrome, consideration of quality of life when making the decision to use extracorporeal support, and the use of the Extracorporeal Life Support Organization registry to report all extracorporeal support activity, among others.

CONCLUSIONS:

Pediatric extracorporeal membrane oxygenation for pediatric acute respiratory distress syndrome could benefit from more specific data collection and collaboration of focused investigators to establish validated criteria for optimal application of extracorporeal membrane oxygenation and patient management protocols. Until that time, consensus opinion offers some insight into guidelines.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório do Recém-Nascido / Oxigenação por Membrana Extracorpórea Tipo de estudo: Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: Pediatr Crit Care Med Assunto da revista: PEDIATRIA / TERAPIA INTENSIVA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório do Recém-Nascido / Oxigenação por Membrana Extracorpórea Tipo de estudo: Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: Pediatr Crit Care Med Assunto da revista: PEDIATRIA / TERAPIA INTENSIVA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Reino Unido