Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting
Abstract Objectives Extracorporeal membrane oxygenation (ECMO) involves complex coagulation management and frequent hemostatic complications. ECMO practice between centers is variable. To compare results between coagulation studies, standardized definitions and clear documentation of ECMO practice i...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-02-01
|
| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12687 |
| _version_ | 1827850965432139776 |
|---|---|
| author | Joppe Drop Suelyn Van Den Helm Paul Monagle Enno Wildschut Matthijs deHoog Sabrina T.G. Gunput Fiona Newall Heidi J. Dalton Graeme MacLaren Vera Ignjatovic C. Heleen vanOmmen |
| author_facet | Joppe Drop Suelyn Van Den Helm Paul Monagle Enno Wildschut Matthijs deHoog Sabrina T.G. Gunput Fiona Newall Heidi J. Dalton Graeme MacLaren Vera Ignjatovic C. Heleen vanOmmen |
| author_sort | Joppe Drop |
| collection | DOAJ |
| description | Abstract Objectives Extracorporeal membrane oxygenation (ECMO) involves complex coagulation management and frequent hemostatic complications. ECMO practice between centers is variable. To compare results between coagulation studies, standardized definitions and clear documentation of ECMO practice is essential. We assessed how study population, outcome definitions, and ECMO‐, coagulation‐, and transfusion‐related parameters were described in pediatric ECMO studies. Data sources Embase, Medline, Web of Science, Cochrane Library and Google Scholar. Study selection English original studies of pediatric ECMO patients describing hemostatic tests or outcome. Data extraction Eligibility was assessed following PRISMA guidelines. Study population, outcome and ECMO‐, coagulation, and transfusion parameters were summarized. Data synthesis A total of 107 of 1312 records were included. Study population parameters most frequently included (gestational) age (79%), gender (60%), and (birth) weight (59%). Outcomes, including definitions of bleeding (29%), thrombosis (15%), and survival (43%), were described using various definitions. Description of pump type, oxygenator and cannulation mode occurred in 49%, 45%, and 36% of studies, respectively. The main coagulation test (53%), its reference ranges (49%), and frequency of testing (24%) were the most prevalent reported coagulation parameters. The transfusion thresholds for platelets, red blood cells, and fibrinogen were described in 27%, 18%, and 18% of studies, respectively. Conclusions This systematic review demonstrates a widespread lack of detail or standardization of several parameters in coagulation research of pediatric ECMO patients. We suggest several parameters that might be included in future coagulation studies. We encourage the ECMO community to adopt and refine this list of parameters and to use standardized definitions in future research. |
| first_indexed | 2024-03-12T10:26:41Z |
| format | Article |
| id | doaj.art-59a3fa1a61b94fc599e5d0ba959ae7e3 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T10:26:41Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-59a3fa1a61b94fc599e5d0ba959ae7e32023-09-02T09:41:33ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792022-02-0162n/an/a10.1002/rth2.12687Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reportingJoppe Drop0Suelyn Van Den Helm1Paul Monagle2Enno Wildschut3Matthijs deHoog4Sabrina T.G. Gunput5Fiona Newall6Heidi J. Dalton7Graeme MacLaren8Vera Ignjatovic9C. Heleen vanOmmen10Pediatric Hematology Erasmus University Medical Center – Sophia Children’s Hospital Rotterdam The NetherlandsHematology Murdoch Children’s Research Institute Melbourne Victoria AustraliaHematology Murdoch Children’s Research Institute Melbourne Victoria AustraliaPediatric Intensive Care Erasmus University Medical Center – Sophia Children’s Hospital Rotterdam The NetherlandsPediatric Intensive Care Erasmus University Medical Center – Sophia Children’s Hospital Rotterdam The NetherlandsMedical Library Erasmus MC University Medical Center Rotterdam The NetherlandsHematology Murdoch Children’s Research Institute Melbourne Victoria AustraliaDepartment of Pediatrics INOVA Heart and Vascular Institute Falls Church Virginia USAHematology Murdoch Children’s Research Institute Melbourne Victoria AustraliaHematology Murdoch Children’s Research Institute Melbourne Victoria AustraliaPediatric Hematology Erasmus University Medical Center – Sophia Children’s Hospital Rotterdam The NetherlandsAbstract Objectives Extracorporeal membrane oxygenation (ECMO) involves complex coagulation management and frequent hemostatic complications. ECMO practice between centers is variable. To compare results between coagulation studies, standardized definitions and clear documentation of ECMO practice is essential. We assessed how study population, outcome definitions, and ECMO‐, coagulation‐, and transfusion‐related parameters were described in pediatric ECMO studies. Data sources Embase, Medline, Web of Science, Cochrane Library and Google Scholar. Study selection English original studies of pediatric ECMO patients describing hemostatic tests or outcome. Data extraction Eligibility was assessed following PRISMA guidelines. Study population, outcome and ECMO‐, coagulation, and transfusion parameters were summarized. Data synthesis A total of 107 of 1312 records were included. Study population parameters most frequently included (gestational) age (79%), gender (60%), and (birth) weight (59%). Outcomes, including definitions of bleeding (29%), thrombosis (15%), and survival (43%), were described using various definitions. Description of pump type, oxygenator and cannulation mode occurred in 49%, 45%, and 36% of studies, respectively. The main coagulation test (53%), its reference ranges (49%), and frequency of testing (24%) were the most prevalent reported coagulation parameters. The transfusion thresholds for platelets, red blood cells, and fibrinogen were described in 27%, 18%, and 18% of studies, respectively. Conclusions This systematic review demonstrates a widespread lack of detail or standardization of several parameters in coagulation research of pediatric ECMO patients. We suggest several parameters that might be included in future coagulation studies. We encourage the ECMO community to adopt and refine this list of parameters and to use standardized definitions in future research.https://doi.org/10.1002/rth2.12687blood coagulationblood coagulation testcritical care outcomesextracorporeal membrane oxygenationpediatricsreference values |
| spellingShingle | Joppe Drop Suelyn Van Den Helm Paul Monagle Enno Wildschut Matthijs deHoog Sabrina T.G. Gunput Fiona Newall Heidi J. Dalton Graeme MacLaren Vera Ignjatovic C. Heleen vanOmmen Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting Research and Practice in Thrombosis and Haemostasis blood coagulation blood coagulation test critical care outcomes extracorporeal membrane oxygenation pediatrics reference values |
| title | Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting |
| title_full | Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting |
| title_fullStr | Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting |
| title_full_unstemmed | Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting |
| title_short | Coagulation in pediatric extracorporeal membrane oxygenation: A systematic review of studies shows lack of standardized reporting |
| title_sort | coagulation in pediatric extracorporeal membrane oxygenation a systematic review of studies shows lack of standardized reporting |
| topic | blood coagulation blood coagulation test critical care outcomes extracorporeal membrane oxygenation pediatrics reference values |
| url | https://doi.org/10.1002/rth2.12687 |
| work_keys_str_mv | AT joppedrop coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT suelynvandenhelm coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT paulmonagle coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT ennowildschut coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT matthijsdehoog coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT sabrinatggunput coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT fionanewall coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT heidijdalton coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT graememaclaren coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT veraignjatovic coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting AT cheleenvanommen coagulationinpediatricextracorporealmembraneoxygenationasystematicreviewofstudiesshowslackofstandardizedreporting |