Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference

Peta M. Alexander, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA.
Melania M. Bembea, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Katherine Cashen, Department of Pediatrics, Duke Children's Hospital, Duke University, Durham, NC.
Ira M. Cheifetz, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH.
Heidi J. Dalton, Department of Pediatrics, INOVA Fairfax Medical Center, Falls Church, VA.
Adam S. Himebauch, Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
Oliver Karam, Division of Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, VA.
Katie M. Moynihan, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA.
Marianne E. Nellis, Department of Pediatrics, Division of Pediatric Critical Care Medicine, New York Presbyterian Hospital-Weill Cornell, New York, NY.
Caroline Ozment, Division of Critical Care Medicine, Department of Pediatrics, Duke University and Duke University Health System, Durham, NC.
Lakshmi Raman, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
Natalie E. Rintoul, Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Ahmed S. Said, Division of Pediatric Critical Care, Department of Pediatrics, Washington University in St. Louis, St. Louis, MO.
Arun Saini, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
Marie E. Steiner, Department of Pediatrics, Divisions of Hematology and Critical Care, University of Minnesota, Minneapolis, MN.
Ravi R. Thiagarajan, Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA.
Kevin Watt, Division of Clinical Pharmacology, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
Ariane Willems, Pediatric Intensive Care Unit, Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands.
Nicole D. Zantek, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
Ryan P. Barbaro, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.
Katherine Steffen, Department of Pediatrics (Pediatric Critical Care Medicine), Stanford University, Palo Alto, CA.
Adam M. Vogel, Departments of Surgery and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX.
Christopher Almond, Department of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA.
Marc M. Anders, Department of Pediatrics, Section of Pediatric Critical Care Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
Gail M. Annich, Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Leonardo R. Brandão, Department of Pediatrics, The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Wayne Chandler, Department of Laboratories, Seattle Children's Hospital, Seattle, WA.
Megan Delaney, Division of Pathology and Lab Medicine and Transfusion Medicine, Children's National Hospital, Washington, DC.
Robert DiGeronimo, Department of Pediatrics, Division of Neonatology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA.
Sitaram Emani, Department of Cardiovascular Surgery, Boston Children's Hospital, and Department of Surgery, Harvard Medical School, Boston, MA.
Samir K. Gadepalli, Division of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
Alejandro V. Garcia, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Document Type

Journal Article

Publication Date

7-1-2024

Journal

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Volume

25

Issue

7

DOI

10.1097/PCC.0000000000003480

Abstract

OBJECTIVES: To present recommendations and consensus statements with supporting literature for the clinical management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE) consensus conference. DATA SOURCES: Systematic review was performed using PubMed, Embase, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021, followed by serial meetings of international, interprofessional experts in the management ECMO for critically ill children. STUDY SELECTION: The management of ECMO anticoagulation for critically ill children. DATA EXTRACTION: Within each of eight subgroup, two authors reviewed all citations independently, with a third independent reviewer resolving any conflicts. DATA SYNTHESIS: A systematic review was conducted using MEDLINE, Embase, and Cochrane Library databases, from January 1988 to May 2021. Each panel developed evidence-based and, when evidence was insufficient, expert-based statements for the clinical management of anticoagulation for children supported with ECMO. These statements were reviewed and ratified by 48 PEACE experts. Consensus was obtained using the Research and Development/UCLA Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. We developed 23 recommendations, 52 expert consensus statements, and 16 good practice statements covering the management of ECMO anticoagulation in three broad categories: general care and monitoring; perioperative care; and nonprocedural bleeding or thrombosis. Gaps in knowledge and research priorities were identified, along with three research focused good practice statements. CONCLUSIONS: The 91 statements focused on clinical care will form the basis for standardization and future clinical trials.

Department

Pathology

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