Electronic searches of MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).
The search used a medical subject heading terms and text words to capture studies of ECMO in PARDS or acute respiratory failure. Studies using animal models and case reports were excluded from our review.
Title/abstract review, full-text review, and data extraction using a standardized data collection form.
The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. There were 18 studies identified for full-text extraction. When pediatric data was lacking, adult and neonatal data from randomized clinical trials and observational studies were considered. Six clinical recommendations were generated related to ECMO indications, initiation, and management in PARDS. There were three good practice statements generated related to ECMO indications, initiation, and follow-up in PARDS. Two policy statements were generated involving the impact of ECMO team organization and training in PARDS. Last, there was one research statement.
Based on a systematic literature review, we propose clinical management, good practice and policy statements within the domains of ECMO indications, initiation, team organization, team training, management, and follow-up as they relate to PARDS.
方法:电子搜索MEDLINE(Ovid),Embase(Elsevier),和CINAHL完成(EBSCOhost)。
方法:搜索使用医学主题标题术语和文本词捕获ECMO在PARDS或急性呼吸衰竭中的研究。我们的综述中排除了使用动物模型和病例报告的研究。
方法:标题/摘要评论,全文回顾,和使用标准化的数据收集表格进行数据提取。
结果:建议评估的分级,发展,采用评估方法进行证据识别和总结,并提出建议。有18项研究确定用于全文提取。当缺乏儿科数据时,我们考虑了来自随机临床试验和观察性研究的成人和新生儿数据.产生了与ECMO适应症相关的六项临床建议,initiation,和PARDS的管理。产生了三个与ECMO适应症有关的良好做法声明,initiation,以及PARDS的后续行动。产生了两个政策声明,涉及ECMO团队组织和PARDS培训的影响。最后,有一个研究声明。
结论:基于系统的文献综述,我们提出临床管理,ECMO适应症领域内的良好做法和政策声明,initiation,团队组织,团队训练,管理,以及与PARDS相关的后续行动。