Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2019
Bleeding Scales Applicable to Critically Ill Children: A Systematic Review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Nellis Marianne E, Levasseur Julie, Stribling Judy, Faustino E Vincent S, Zantek Nicole D, Sheth Sujit, Karam Oliver
Аннотация
OBJECTIVES: To summarize current bleeding scales and their validation to assess applicability to bleeding in critically ill children.
DATA SOURCES: We conducted electronic searches of Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and Web of Science Core Collection databases from database inception to 2017.
STUDY SELECTION: Included studies contained a bleeding score, bleeding measurement tool, or clinical measurement of hemorrhage.
DATA EXTRACTION: We identified 2,097 unique citations; 20 full-text articles were included in the final review.
DATA SYNTHESIS: Of the 18 studies that included subjects (two others were expert consensus definitions), seven (39%) were pediatric-only, seven (39%) were adult-only, and four (22%) included both adults and children. Nine (50%) occurred with inpatients (two studies in critical care units), seven (39%) involved outpatients and two (11%) included both inpatients and outpatients. Thirty-nine percent of the scales were developed for those with idiopathic thrombocytopenic purpura and only two (12%) described critically ill patients. The majority (80%) included need for treatment (either RBC transfusion or surgical intervention). The majority (65%) did not report measures of reliability or validation to clinical outcomes.
CONCLUSIONS: There is a lack of validated bleeding scales to adequately assess bleeding and outcomes in critically ill children. Validated scales of bleeding are necessary and urgently needed.
DATA SOURCES: We conducted electronic searches of Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and Web of Science Core Collection databases from database inception to 2017.
STUDY SELECTION: Included studies contained a bleeding score, bleeding measurement tool, or clinical measurement of hemorrhage.
DATA EXTRACTION: We identified 2,097 unique citations; 20 full-text articles were included in the final review.
DATA SYNTHESIS: Of the 18 studies that included subjects (two others were expert consensus definitions), seven (39%) were pediatric-only, seven (39%) were adult-only, and four (22%) included both adults and children. Nine (50%) occurred with inpatients (two studies in critical care units), seven (39%) involved outpatients and two (11%) included both inpatients and outpatients. Thirty-nine percent of the scales were developed for those with idiopathic thrombocytopenic purpura and only two (12%) described critically ill patients. The majority (80%) included need for treatment (either RBC transfusion or surgical intervention). The majority (65%) did not report measures of reliability or validation to clinical outcomes.
CONCLUSIONS: There is a lack of validated bleeding scales to adequately assess bleeding and outcomes in critically ill children. Validated scales of bleeding are necessary and urgently needed.