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体外膜肺氧合支持下的新生儿和儿科患者常规神经监测临床指南

Clinical Guidelines for Routine Neuromonitoring in Neonatal and Pediatric Patients Supported on Extracorporeal Membrane Oxygenation.

作者信息

Pandiyan Poornima, Cvetkovic Mirjana, Antonini Marta Velia, Shappley Rebekah K H, Karmakar Swati A, Raman Lakshmi

机构信息

From the Department of Pediatrics, Division of Medical Critical Care, Boston Children's Hospital, Tufts University School of Medicine, Boston, Massachusetts.

Cardiac Critical Care Division, Heart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

出版信息

ASAIO J. 2023 Oct 1;69(10):895-900. doi: 10.1097/MAT.0000000000001896. Epub 2023 Aug 21.

Abstract

These guidelines for routine neuromonitoring in neonatal and pediatric patients supported on extracorporeal membrane oxygenation (ECMO) are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing extracorporeal life support (ECLS)/ECMO and describe what are believed to be useful and safe practice for ECLS and ECMO but these are not necessarily consensus recommendations. The aim of clinical guidelines was to help clinicians to make informed decisions about their patients. However, adherence to a guideline does not guarantee a successful outcome. Healthcare professionals must make their own treatment decisions about care on a case-by-case basis, after consultation with their patients, using their clinical judgment, knowledge, and expertise. These guidelines do not take the place of physicians' and other health professionals' judgment in diagnosing and treatment of patients. These guidelines are not intended to and should not be interpreted as setting a standard of care or being deemed inclusive of all proper methods of care nor exclusive of other methods of care directed at obtaining the same results. The ultimate judgment must be made by the physician and other health professionals and the patient considering all the circumstances presented by the individual patient, and the known variability and biologic behavior of the clinical condition. These guidelines reflect the data at the time the guidelines were prepared; the results of subsequent studies or other information may cause revisions to the recommendations in these guidelines to be prudent to reflect new data, but ELSO is under no obligation to provide updates. In no event will ELSO be liable for any decision made or action taken in reliance upon the information provided through these guidelines.

摘要

这些关于体外膜肺氧合(ECMO)支持下的新生儿和儿科患者常规神经监测的指南旨在用于教育目的,以增进医生和其他医疗专业人员在评估接受体外生命支持(ECLS)/ECMO患者的病情及管理治疗方面的知识,并描述被认为对ECLS和ECMO有用且安全的做法,但这些不一定是共识性建议。临床指南的目的是帮助临床医生对其患者做出明智的决策。然而,遵循指南并不能保证取得成功的结果。医疗专业人员必须在与患者协商后,根据具体情况,运用他们的临床判断、知识和专业技能,自行做出关于治疗护理的决策。这些指南不能替代医生和其他医疗专业人员在诊断和治疗患者时的判断。这些指南无意也不应被解释为设定护理标准,或被视为涵盖所有适当的护理方法,也不排除旨在获得相同结果的其他护理方法。最终的判断必须由医生、其他医疗专业人员以及患者在考虑个体患者呈现的所有情况以及临床病症已知的变异性和生物学行为后做出。这些指南反映了制定指南时的数据;后续研究结果或其他信息可能导致对这些指南中的建议进行修订,以谨慎反映新数据,但体外生命支持组织(ELSO)没有义务提供更新。在任何情况下,ELSO均不对依赖这些指南所提供信息而做出的任何决策或采取的任何行动承担责任。

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