Abstract：
Previous criteria for coagulation dysfunction in critically ill children were based mainly on expert opinion.
To evaluate current evidence regarding coagulation tests associated with adverse outcomes in children to inform criteria for coagulation dysfunction during critical illness.
Electronic searches of PubMed and Embase were conducted from January 1992 to January 2020 by using a combination of medical subject heading terms and text words to define concepts of coagulation dysfunction, pediatric critical illness, and outcomes of interest.
Studies were included if critically ill children with coagulation dysfunction were evaluated, if performance characteristics of assessment and/or scoring tools to screen for coagulation dysfunction were evaluated, and if outcomes related to mortality or functional status, organ-specific outcomes, or other patient-centered outcomes were assessed.
Data were abstracted from each eligible study into a standard data extraction form, along with risk of bias assessment, by a task force member.
The systematic review supports the presence of at least 2 of the following criteria reflecting coagulation dysfunction in the absence of liver dysfunction: platelet count <100 000 cells per μL, international normalized ratio >1.5, fibrinogen level <150 mg/dL, and D-dimer value above 10 times the upper limit of normal, or above the assay\'s upper limit of detection if this limit is below 10 times the upper limit of normal.
The proposed criteria for coagulation dysfunction are limited by the available evidence and will require future validation.
Validation of the proposed criteria and identified scientific priorities will enhance our understanding of coagulation dysfunction in critically ill children.
To evaluate current evidence regarding coagulation tests associated with adverse outcomes in children to inform criteria for coagulation dysfunction during critical illness.
Electronic searches of PubMed and Embase were conducted from January 1992 to January 2020 by using a combination of medical subject heading terms and text words to define concepts of coagulation dysfunction, pediatric critical illness, and outcomes of interest.
Studies were included if critically ill children with coagulation dysfunction were evaluated, if performance characteristics of assessment and/or scoring tools to screen for coagulation dysfunction were evaluated, and if outcomes related to mortality or functional status, organ-specific outcomes, or other patient-centered outcomes were assessed.
Data were abstracted from each eligible study into a standard data extraction form, along with risk of bias assessment, by a task force member.
The systematic review supports the presence of at least 2 of the following criteria reflecting coagulation dysfunction in the absence of liver dysfunction: platelet count <100 000 cells per μL, international normalized ratio >1.5, fibrinogen level <150 mg/dL, and D-dimer value above 10 times the upper limit of normal, or above the assay\'s upper limit of detection if this limit is below 10 times the upper limit of normal.
The proposed criteria for coagulation dysfunction are limited by the available evidence and will require future validation.
Validation of the proposed criteria and identified scientific priorities will enhance our understanding of coagulation dysfunction in critically ill children.
摘要：
先前危重患儿凝血功能障碍的标准主要基于专家意见。
评估当前关于儿童不良结局的凝血测试的证据，以告知危重病期间凝血功能障碍的标准。
从1992年1月至2020年1月，通过使用医学主题标题术语和文本词的组合来定义凝血功能障碍的概念，对PubMed和Embase进行了电子搜索。儿科危重症,和感兴趣的结果。
如果对有凝血功能障碍的危重患儿进行评估，如果评估了用于筛查凝血功能障碍的评估和/或评分工具的性能特征，如果结果与死亡率或功能状态有关，器官特异性结果，或评估其他以患者为中心的结局.
将每项符合条件的研究中的数据抽象为标准的数据提取表，连同偏见风险评估，特遣部队成员。
系统评价支持在没有肝功能障碍的情况下至少存在以下两种反映凝血功能障碍的标准：血小板计数<100000个细胞/μL，国际标准化比率>1.5，纤维蛋白原水平<150mg/dL，D-二聚体值高于正常上限的10倍，如果该限度低于正常上限的10倍，则高于测定的检测上限。
凝血功能障碍的拟议标准受到现有证据的限制，需要进一步验证。
验证拟议标准和确定的科学优先事项将增强我们对危重患儿凝血功能障碍的理解。
评估当前关于儿童不良结局的凝血测试的证据，以告知危重病期间凝血功能障碍的标准。
从1992年1月至2020年1月，通过使用医学主题标题术语和文本词的组合来定义凝血功能障碍的概念，对PubMed和Embase进行了电子搜索。儿科危重症,和感兴趣的结果。
如果对有凝血功能障碍的危重患儿进行评估，如果评估了用于筛查凝血功能障碍的评估和/或评分工具的性能特征，如果结果与死亡率或功能状态有关，器官特异性结果，或评估其他以患者为中心的结局.
将每项符合条件的研究中的数据抽象为标准的数据提取表，连同偏见风险评估，特遣部队成员。
系统评价支持在没有肝功能障碍的情况下至少存在以下两种反映凝血功能障碍的标准：血小板计数<100000个细胞/μL，国际标准化比率>1.5，纤维蛋白原水平<150mg/dL，D-二聚体值高于正常上限的10倍，如果该限度低于正常上限的10倍，则高于测定的检测上限。
凝血功能障碍的拟议标准受到现有证据的限制，需要进一步验证。
验证拟议标准和确定的科学优先事项将增强我们对危重患儿凝血功能障碍的理解。
