Pediatric Stem Cell Transplantation and Cellular Therapy, MD Anderson Children's Cancer Hospital Houston, The University of Texas, Houston, Texas.
Department of Pediatric Critical Care Medicine, St Jude Children's Research Hospital Memphis, Memphis, Tennessee.
Biol Blood Marrow Transplant. 2017 Dec;23(12):2023-2033. doi: 10.1016/j.bbmt.2017.08.014. Epub 2017 Aug 17.
Even though hepatic veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic cell transplantation (HCT), there is paucity of research on the management of associated multiorgan dysfunction. To help provide standardized care for the management of these patients, the HCT Subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators and the Supportive Care Committee of the Pediatric Blood and Marrow Transplant Consortium, collaborated to develop evidence-based consensus guidelines. After conducting an extensive literature search, in part 2 of this series we discuss the management of fluids and electrolytes, renal dysfunction; ascites, pleural effusion, and transfusion and coagulopathy issues in patients with VOD. We consider the available evidence using the GRADE criteria.
尽管肝静脉闭塞病(VOD)是造血细胞移植(HCT)的一种潜在致命并发症,但对于相关多器官功能障碍的治疗研究甚少。为了帮助为这些患者的管理提供标准化的护理,HCT 亚组的儿科急性肺损伤和脓毒症研究人员以及儿科血液和骨髓移植联盟的支持性护理委员会合作制定了循证共识指南。在进行了广泛的文献检索之后,在本系列的第 2 部分中,我们讨论了 VOD 患者的液体和电解质、肾功能障碍、腹水、胸腔积液以及输血和凝血障碍问题的管理。我们使用 GRADE 标准考虑了现有证据。