Sethi Sidharth Kumar, Mittal Aliza, Nair Nikhil, Bagga Arvind, Iyenger Arpana, Ali Uma, Sinha Rajiv, Agarwal Indira, de Sousa Tavares Marcelo, Abeyagunawardena Asiri, Hanif Mohammed, Shreshtha Devender, Moorani Khemchand, Asim Sadaf, Kher Vijay, Alhasan Khalid, Mourani Chebl, Al Riyami Mohammed, Bunchman Timothy E, McCulloch Mignon, Raina Rupesh
Pediatric Nephrology, Medanta, The Medicity, Gurgaon, India.
Pediatrics, AIIMS, Jodhpur, Rajasthan, India.
Hemodial Int. 2020 Apr;24(2):237-251. doi: 10.1111/hdi.12821. Epub 2020 Feb 18.
Recently, prolonged intermittent renal replacement therapies (PIRRT) have emerged as cost-effective alternatives to conventional CRRT and their use in the pediatric population has started to become more prominent. However, there is a lack of consensus guidelines on the use of PIRRT in pediatric patients in an intensive care setting.
A literature search was performed on PubMed/Medline, Embase, and Google Scholar in conjunction with medical librarians from both India and the Cleveland Clinic hospital system to find relevant articles. The Pediatric Continuous Renal Replacement Therapy workgroup analyzed all articles for relevancy, proposed recommendations, and graded each recommendation for their strength of evidence.
Of the 60 studies eligible for review, the workgroup considered data from 37 studies to formulate guidelines for the use of PIRRT in children. The guidelines focused on the definition, indications, machines, and prescription of PIRRT.
Although the literature on the use of PIRRT in children is limited, the current studies give credence to their benefits and these expert recommendations are a valuable first step in the continued study of PIRRT in the pediatric population.
最近,延长间歇性肾脏替代疗法(PIRRT)已成为传统连续性肾脏替代疗法(CRRT)具有成本效益的替代方案,并且其在儿科人群中的应用开始变得更加突出。然而,在重症监护环境中,关于PIRRT在儿科患者中的使用缺乏共识性指南。
与来自印度和克利夫兰诊所医院系统的医学图书馆员合作,在PubMed/Medline、Embase和谷歌学术上进行文献检索,以查找相关文章。儿科连续性肾脏替代疗法工作组分析了所有文章的相关性,提出了建议,并对每个建议的证据强度进行了分级。
在60项符合审查条件的研究中,工作组考虑了37项研究的数据,以制定儿童使用PIRRT的指南。这些指南重点关注PIRRT的定义、适应症、设备和处方。
尽管关于PIRRT在儿童中使用的文献有限,但目前的研究证实了其益处,这些专家建议是在儿科人群中继续研究PIRRT的有价值的第一步。