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Extracorporeal Blood Purification in European Pediatric Intensive Care Units: A Consensus Statement
G. Bottari, E. Buccione, B. Bayrakci, G. Briassoulis, MJ. Carter, D. Demirkol, S. Ilia, L. Morin, K. Reiter, MJ. Santiago, LJ. Schlapbach, M. Slocker-Barrio, P. Tissieres, T. Zaoral, S. Bianzina, A. Deep
Language English Country United States
Document type Journal Article
NLK
Directory of Open Access Journals
from 2018
ProQuest Central
from 2018-01-01
Health & Medicine (ProQuest)
from 2018-01-01
ROAD: Directory of Open Access Scholarly Resources
from 2018
- MeSH
- Delphi Technique MeSH
- Child MeSH
- Hemofiltration methods standards MeSH
- Intensive Care Units, Pediatric * standards MeSH
- Consensus * MeSH
- Humans MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
IMPORTANCE: Important advances have been made in extracorporeal blood purification therapies (EBPTs) due to new technologies and biomaterials; however, the lack of established guidelines is a factor in great variability in clinical practice. This aspect is accentuated in pediatric intensive care given the small number of patients with diverse diagnoses treated with EBPT and the technical challenges in treating small children, potentiating the risk of adverse events. OBJECTIVE: To understand what experienced users of EBPT think about its relevant issues, insight that may have implications for the design of future studies, and the application of EBPTs in patient care. EVIDENCE REVIEW: Literature search was conducted using the PubMed and Embase databases between January 1, 2020, and July 15, 2024, and a combination of key medical terms. A panel of experts was formed (composed of 15 authors and pediatric intensivists) to develop a consensus statement using a modified Delphi-based model between 2022 and 2024. The panel's core team drafted the initial questionnaire, which explored EBPT use in pediatric intensive care units (PICUs), including clinical indications for initiating and discontinuing use and outcomes for assessing effectiveness and safety. SurveyMonkey was used in the distribution, completion, and revision of the questionnaire, and findings were analyzed. Panelists were asked to rank answer choices. Numerical value for each ranking was translated to a percentage defining the strength of consensus (>90% agreement from panelists signifying strong consensus; <49% signifying no consensus). FINDINGS: A total of 116 survey responses were received from panelists from 8 European countries. Strong consensus was achieved on 6 of 24 questions and consensus (75%-90% agreement) was reached on 18 of 24 questions. According to the panelists, the continuous renal replacement therapy standard or enhanced adsorption hemofilter and plasma exchange were of interest, representing the most applied EBPTs across various applications. While evidence on hemoadsorption is growing, it remains limited. CONCLUSIONS AND RELEVANCE: This consensus statement on EBPTs in critically ill pediatric patients was developed by an international panel of experts in areas where clinical evidence is still limited. This consensus statement could support pediatric intensivists in bedside decision-making and guide future research on EBPTs in PICUs.
Child Health Research Centre The University of Queensland Brisbane Queensland Australia
Department of Pediatric Intensive Care Istanbul Faculty of Medicine Istanbul Türkiye
Faculty of Medicine Paris Saclay University France
Imperial College London London United Kingdom
Neonatal Intensive Care Unit Health Local Authority 3 of Pescara Pescara Italy
Pediatric Intensive Care AP HP Paris Saclay University Bicêtre Hospital Le Kremlin Bicêtre France
Pediatric Intensive Care Unit Bambino Gesù Children's Hospital Rome Italy
Pediatric Intensive Care Unit King's College Hospital London United Kingdom
References provided by Crossref.org
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