Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
33657677
DOI
10.1111/bjd.19893
Knihovny.cz E-zdroje
- MeSH
- dítě MeSH
- dospělí MeSH
- konsensus MeSH
- lidé MeSH
- retrospektivní studie MeSH
- Stevensův-Johnsonův syndrom * diagnóza terapie MeSH
- výzkum MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. OBJECTIVES: Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. METHODS: Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. RESULTS: Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. CONCLUSIONS: We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.
Beth Israel Deaconess Medical Center Harvard Medical School Boston MA USA
Birmingham Children's Hospital and University of Birmingham Birmingham UK
Christine Kühne Center for Allergy Research and Education Davos Switzerland
Clinical Experimental Sciences Faculty of Medicine University of Southampton Southampton UK
Department of Dermatology Aarhus University Hospital Palle Juul Jensens Aarhus Denmark
Department of Dermatology and Allergy University Hospital of Munich LMU Munich Germany
Department of Dermatology AP HP Necker Hospital Paris France
Department of Dermatology Brigham and Women's Hospital Harvard Medical School Boston MA USA
Department of Dermatology CHU Bordeaux Bordeaux France
Department of Dermatology CHU Charles Nicolle Rouen France
Department of Dermatology King's College Hospital London UK
Department of Dermatology Kyorin University School of Medicine Tokyo Japan
Department of Dermatology Leiden University Medical Center Leiden the Netherlands
Department of Dermatology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
Department of Dermatology University Hospital Zurich Zurich Switzerland
Department of Dermatology University of California Davis Sacramento CA USA
Department of Dermatology University of California San Francisco CA USA
Department of Medicine and Pharmacology Vanderbilt University Medical Center Nashville TN USA
Department of Psychiatry AP HP Henri Mondor Albert Chenevier Hospitals Cr France
Dermatology Department AP HP Henri Mondor Hospital Créteil France
Division of Clinical Pharmacology and Toxicology University of Toronto Toronto ON Canada
Division of Dermatology Department of Internal Medicine Ohio State University Columbus OH USA
Division of Dermatology Sunnybrook Health Sciences Centre Toronto ON Canada
Faculty of Medicine University of Zurich Zurich Switzerland
Intensive Care Unit AP HP Henri Mondor Hospital Créteil France
Keck USC School of Medicine Los Angeles CA USA
Macmillan Skin Cancer CNS Normanby Building Denmark Hill London UK
Massachusetts General Hospital Harvard Medical School Boston MA USA
Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
Ophthalmology Department Hospital Charles Nicolle EA7510 UFR Santé Rouen University Rouen France
Réanimation Chirurgicale et des Brûlés PTMC CHU Nantes Nantes France
ToxiTEN Group European Reference Network for Rare Skin Diseases Paris France
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