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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合会关于支持性护理指南的共识报告:管理儿童和青少年静脉阻塞性疾病的第 2 部分 - 重点关注腹水、液体和电解质、肾脏和输血问题。

Consensus Report by the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplant Consortium Joint Working Committees on Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents: Part 2-Focus on Ascites, Fluid and Electrolytes, Renal, and Transfusion Issues.

机构信息

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.

出版信息

Biol Blood Marrow Transplant. 2017 Dec;23(12):2023-2033. doi: 10.1016/j.bbmt.2017.08.014. Epub 2017 Aug 17.

DOI:10.1016/j.bbmt.2017.08.014
PMID:28823876
Abstract

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.

摘要

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。

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1
Consensus Report by the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplant Consortium Joint Working Committees on Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents: Part 2-Focus on Ascites, Fluid and Electrolytes, Renal, and Transfusion Issues.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合会关于支持性护理指南的共识报告:管理儿童和青少年静脉阻塞性疾病的第 2 部分 - 重点关注腹水、液体和电解质、肾脏和输血问题。
Biol Blood Marrow Transplant. 2017 Dec;23(12):2023-2033. doi: 10.1016/j.bbmt.2017.08.014. Epub 2017 Aug 17.
2
Consensus Report by Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplantation Consortium Joint Working Committees: Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents, Part 1: Focus on Investigations, Prophylaxis, and Specific Treatment.儿科急性肺损伤和脓毒症研究人员与儿科血液和骨髓移植联盟联合工作组共识报告:静脉阻塞性疾病患儿和青少年管理的支持性治疗指南,第 1 部分:重点关注检查、预防和具体治疗。
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High Variability in the Reported Management of Hepatic Veno-Occlusive Disease in Children after Hematopoietic Stem Cell Transplantation.造血干细胞移植后儿童肝静脉闭塞病报告管理的高度变异性。
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Defibrotide for the Treatment of Hepatic Veno-Occlusive Disease: Final Results From the International Compassionate-Use Program.去纤苷治疗肝静脉闭塞病:国际同情用药项目的最终结果
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Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno-occlusive disease.
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Earlier defibrotide initiation post-diagnosis of veno-occlusive disease/sinusoidal obstruction syndrome improves Day +100 survival following haematopoietic stem cell transplantation.造血干细胞移植后,在静脉闭塞性疾病/窦性阻塞综合征诊断后更早开始使用去纤苷可提高第100天的生存率。
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引用本文的文献

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Pediatr Blood Cancer. 2025 Mar;72(3):e31473. doi: 10.1002/pbc.31473. Epub 2024 Dec 9.
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Hospital survival following pediatric HSCT: changes in complications, ICU therapies and outcomes over 10 years.儿童造血干细胞移植后的医院生存率:10年间并发症、重症监护室治疗及预后的变化
Front Pediatr. 2023 Oct 12;11:1247792. doi: 10.3389/fped.2023.1247792. eCollection 2023.
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Kidney Injury in Children after Hematopoietic Stem Cell Transplant.
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Curr Oncol. 2023 Mar 13;30(3):3329-3343. doi: 10.3390/curroncol30030253.
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Continuous Renal Replacement Therapy: A Review of Use and Application in Pediatric Hematopoietic Stem Cell Transplant Recipients.连续性肾脏替代治疗:儿科造血干细胞移植受者的使用与应用综述
Front Oncol. 2021 Feb 26;11:632263. doi: 10.3389/fonc.2021.632263. eCollection 2021.