Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference

Authors

Jennifer A Muszynski
Melania M Bembea
Alison Gehred
Elizabeth Lyman
Katherine Cashen
Ira M Cheifetz
Heidi J Dalton
Adam S Himebauch
Oliver Karam
Katie M Moynihan
Marianne E Nellis
Caroline Ozment
Lakshmi Raman
Natalie E Rintoul
Ahmed Said
Arun Saini
Marie E Steiner
Ravi R Thiagarajan
Kevin Watt
Ariane Willems
Nicole D Zantek
Ryan P Barbaro
Katherine Steffen
Adam M Vogel
Peta M A Alexander

Publication Date

7-1-2024

Journal

Pediatric Critical Care Medicine

DOI

10.1097/PCC.0000000000003488

PMID

38959362

PMCID

PMC11216398

PubMedCentral® Posted Date

7-3-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Extracorporeal Membrane Oxygenation, Humans, Anticoagulants, Child, Infant, Newborn, Critical Illness, Biomedical Research, Infant, Child, Preschool, anticoagulation, blood transfusion, extracorporeal membrane oxygenation, hemolysis, pediatrics

Abstract

OBJECTIVES: To identify and prioritize research questions for anticoagulation and hemostasis management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE) consensus.

DATA SOURCES: Systematic review was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021, followed by serial consensus conferences of international, interprofessional experts in the management of ECMO for critically ill neonates and children.

STUDY SELECTION: The management of ECMO anticoagulation for critically ill neonates and children.

DATA EXTRACTION: Within each of the eight subgroups, two authors reviewed all citations independently, with a third independent reviewer resolving any conflicts.

DATA SYNTHESIS: Following the systematic review of MEDLINE, EMBASE, and Cochrane Library databases from January 1988 to May 2021, and the consensus process for clinical recommendations and consensus statements, PEACE panel experts constructed research priorities using the Child Health and Nutrition Research Initiative methodology. Twenty research topics were prioritized, falling within five domains (definitions and outcomes, therapeutics, anticoagulant monitoring, protocolized management, and impact of the ECMO circuit and its components on hemostasis).

CONCLUSIONS: We present the research priorities identified by the PEACE expert panel after a systematic review of existing evidence informing clinical care of neonates and children managed with ECMO. More research is required within the five identified domains to ultimately inform and improve the care of this vulnerable population.