%0 Journal Article
%T Prophylactic Transfusion Strategies in Children Supported by Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.
%A Nellis ME
%A Moynihan KM
%A Sloan SR
%A Delaney M
%A Kneyber MCJ
%A DiGeronimo R
%A Alexander PMA
%A Muszynski JA
%A Gehred A
%A Lyman E
%A Karam O
%A  
%J Pediatr Crit Care Med
%V 25
%N 7
%D 2024 Jul 1
%M 38959357
%F 3.971
%R 10.1097/PCC.0000000000003493
%X <B>OBJECTIVE: </B>To derive systematic-review informed, modified Delphi consensus regarding prophylactic transfusions in neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE.<BR><B>METHODS: </B>A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2020, with an update in May 2021.<BR><B>METHODS: </B>Included studies assessed use of prophylactic blood product transfusion in pediatric ECMO.<BR><B>METHODS: </B>Two authors reviewed all citations independently, with a third independent reviewer resolving conflicts. Thirty-three references were used for data extraction and informed recommendations. Evidence tables were constructed using a standardized data extraction form.<BR><B>RESULTS: </B>The evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. Forty-eight experts met over 2 years to develop evidence-informed recommendations and, when evidence was lacking, expert-based consensus statements or good practice statements for prophylactic transfusion strategies for children supported with ECMO. A web-based modified Delphi process was used to build consensus via the Research And Development/University of California Appropriateness Method. Consensus was based on a modified Delphi process with agreement defined as greater than 80%. We developed two good practice statements, 4 weak recommendations, and three expert consensus statements.<BR><B>CONCLUSIONS: </B>Despite the frequency with which pediatric ECMO patients are transfused, there is insufficient evidence to formulate evidence-based prophylactic transfusion strategies.