American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis for patients with COVID-19: March 2022 update on the use of anticoagulation in critically ill patients.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cuker Adam, Tseng Eric K, Schünemann Holger J, Angchaisuksiri Pantep, Blair Clifton, Dane Kathryn, DeSancho Maria T, Diuguid David, Griffin Daniel O, Kahn Susan R, Klok Frederikus A, Lee Alfred Ian, Neumann Ignacio, Pai Ashok, Righini Marc, Sanfilippo Kristen M, Siegal Deborah M, Skara Mike, Terrell Deirdra R, Touri Kamshad, Akl Elie A, Al Jabiri Reyad, Al Jabiri Yazan, Boulos Mary, Brignardello-Petersen Romina, Charide Rana, Colunga-Lozano Luis E, Dearness Karin, Darzi Andrea J, Karam Samer G, Morgano Gian Paolo, Morsi Rami Z, Philip Binu A, Benitez Yetiani Roldan, Stevens Adrienne, Solo Karla, Wiercioch Wojtek, Mustafa Reem A, Nieuwlaat Robby
Аннотация
OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for patients with COVID-19.
METHODS: ASH formed a multidisciplinary guideline panel, including 3 patient representatives, and applied strategies to minimize potential bias from conflicts of interest. The McMaster University Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process, including performing systematic evidence reviews (up to January 2022). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the GRADE approach to assess evidence and make recommendations, which were subject to public comment. This is an update to guidelines published in February 2021 and May 2021 as part of the living phase of these guidelines.
RESULTS: The panel made 1 additional recommendation: a conditional recommendation for the use of prophylactic-intensity over therapeutic-intensity anticoagulation for patients with COVID-19-related critical illness who do not have suspected or confirmed VTE. The panel emphasized the need for an individualized assessment of thrombotic and bleeding risk.
CONCLUSIONS: This conditional recommendation was based on very low certainty in the evidence, underscoring the need for additional, high-quality, randomized controlled trials comparing different intensities of anticoagulation for patients with COVID-19-related critical illness.