Bleeding Scales Applicable to Critically Ill Children: A Systematic Review

被引:10
作者
Nellis, Marianne E. [1 ]
Levasseur, Julie [1 ]
Stribling, Judy [2 ]
Faustino, E. Vincent S. [3 ]
Zantek, Nicole D. [4 ]
Sheth, Sujit [5 ]
Karam, Oliver [6 ]
机构
[1] Weill Cornell Med, New York Presbyterian Hosp, Dept Pediat, Pediat Crit Care Med, New York, NY 10065 USA
[2] Weill Cornell Med, Samuel J Wood Lib, New York, NY USA
[3] Yale Sch Med, Sect Pediat Crit Care Med, Dept Pediat, New Haven, CT USA
[4] Univ Minnesota, Dept Lab Med & Pathol, Div Transfus Med, Minneapolis, MN 55455 USA
[5] Weill Cornell Med, Div Pediat Hematol Oncol, Dept Pediat, New York Presbyterian Hosp, New York, NY USA
[6] Virginia Commonwealth Univ, Dept Pediat, Div Pediat Crit Care Med, Childrens Hosp Richmond, Richmond, VA USA
关键词
critical care; critical illness; hemorrhage; intensive care units; pediatrics; severity of illness; IDIOPATHIC THROMBOCYTOPENIC PURPURA; PROPHYLACTIC PLATELET TRANSFUSIONS; VON-WILLEBRAND-DISEASE; PREDNISONE THERAPY; SCORE; VALIDATION; SEVERITY; MANAGEMENT;
D O I
10.1097/PCC.0000000000001943
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:603 / 607
页数:5
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