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住院儿童术前血小板输注阈值——一项范围综述的方案

Pre-procedural platelet transfusion thresholds in hospitalised children - Protocol for a scoping review.

作者信息

Holst Lars Broksø, Afshari Arash, Møller Morten Hylander, Russell Lene

机构信息

Department of Paediatric and Obstetric Anaesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2021 Apr;65(4):558-561. doi: 10.1111/aas.13750. Epub 2020 Nov 29.

Abstract

BACKGROUND

Thrombocytopenia is a common condition in hospitalised critically ill children and most platelet transfusions are given as prophylaxis to non-bleeding children prior to invasive procedures such as central venous catheterisation and lumbar puncture. Platelet transfusion may reduce bleeding complications but have also been associated with potential adverse effects and variation in clinical practice exist. To direct future research, we aim to assess the current evidence regarding prophylactic platelet transfusion prior to procedures in hospitalised thrombocytopenic children.

METHODS

We will conduct a scoping review of all study designs in accordance with the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) statement. We will include studies on hospitalised children undergoing invasive procedures where the prevalence of thrombocytopenia and the predefined outcome measures, including bleeding, transfusion-related adverse events and use of blood products and life support are reported. We will provide descriptive analyses of the included studies/trials and the quality of evidence will be assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

CONCLUSION

The outlined scoping review will provide an overview on the benefits and harms of prophylactic platelet transfusion prior to invasive procedures in thrombocytopenic hospitalised children.

摘要

背景

血小板减少症在住院的危重症儿童中很常见,大多数血小板输注是作为预防性措施,在进行诸如中心静脉置管和腰椎穿刺等侵入性操作之前,给予未出血的儿童。血小板输注可能会减少出血并发症,但也与潜在的不良反应有关,并且临床实践存在差异。为指导未来的研究,我们旨在评估目前关于住院血小板减少症儿童在进行操作前预防性输注血小板的证据。

方法

我们将根据系统评价和Meta分析的首选报告项目(PRISMA)声明,对所有研究设计进行范围综述。我们将纳入有关接受侵入性操作的住院儿童的研究,这些研究报告了血小板减少症的患病率以及预定义的结局指标,包括出血、输血相关不良事件以及血液制品和生命支持的使用情况。我们将对纳入的研究/试验进行描述性分析,并根据推荐意见分级评估、制定和评价(GRADE)方法评估证据质量。

结论

概述的范围综述将提供关于住院血小板减少症儿童在进行侵入性操作前预防性输注血小板的益处和危害的概述。

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