Interventional Strategies for Children with Progressive Pulmonary Hypertension Despite Optimal Therapy. An Official American Thoracic Society Clinical Practice Guideline.

Autor:	Hayes D Jr; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States; Don.Hayes@cchmc.org., Jennerich AL; University of Washington, Division of Pulmonary, Critical Care and Sleep Medicine, Seattle, Washington, United States., Coleman RD; Texas Children's Hospital, Pediatrics, Sections of Critical Care Medicine and Pulmonary Medicine, Houston, Texas, United States.; Baylor College of Medicine, Pediatrics, Sections of Critical Care Medicine and Pulmonary Medicine, Houston, Texas, United States., Abston E; Boston University School of Medicine, Pulmonary, Allergy, Sleep, and Critical Care , Boston, Massachusetts, United States., Adamson GT; Stanford Medicine, Palo Alto, United States., Berger JT; Children's National Medical Center and George Washington University, Pediatrics, Washington, District of Columbia, United States., Cohen SP; Nationwide Children's Hospital, Columbus, Ohio, United States., Cooper DS; Cincinnati Children's Hospital Medical Center, Pediatrics, Cincinnati, Ohio, United States., Eghtesady P; Washington University School of Medicine, Surgery, Saint Louis, Missouri, United States., Fynn-Thompson F; Children's Hospital Boston, Cardiac Surgery, Boston, Massachusetts, United States., Grady RM; St Louis Children's Hospital, St Louis, Missouri, United States., Hon SM; Boston University School of Medicine, The Pulmonary Center, Boston, Massachusetts, United States., Hoopes CW; University of Alabama at Birmingham, Birmingham, Alabama, United States., Jewell T; University of Washington, Seattle, Washington, United States., Lewthwaite H; University of Newcastle, School of Environmental & Life Sciences, College of Engineering, Science and Environment, Ourimbah, Australia., Liu MF; Inova, Falls Church, Virginia, United States., McGiffin DC; The Alfred, Melbourne, Victoria, Australia., Mullen MP; Boston Children's Hospital, Cardiology, Boston, Massachusetts, United States., Qureshi AM; Texas Children's Hospital, Houston, Texas, United States., Morales DLS; Cincinnati Children's Hospital Medical Center, Cardiothoracic Surgery, Cincinnati, Ohio, United States.
Jazyk:	angličtina
Zdroj:	American journal of respiratory and critical care medicine [Am J Respir Crit Care Med] 2024 Nov 12. Date of Electronic Publication: 2024 Nov 12.
DOI:	10.1164/rccm.202410-1901ST
Abstrakt:	Background: Pulmonary hypertension in children often progresses despite optimal therapy. This document provides an evidence-based clinical practice guideline for the management of children with progressive pulmonary hypertension despite optimal therapy. Methods: A multidisciplinary panel identified pertinent questions regarding the management of children with pulmonary hypertension that has progressed despite optimal therapy, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop clinical recommendations. Results: After reviewing the research evidence, the panel considered the balance of desirable (benefits) and undesirable (harms and burdens) effects of the interventions in each proposed question. Valuation of our main outcomes was also considered, along with resources required, equity, acceptability, and feasibility. Recommendations were developed for or against interventional strategies specific to children with pulmonary hypertension that has progressed despite optimal therapy. Conclusions: Although there is a growing population of children with pulmonary hypertension, there is a striking lack of empirical evidence regarding management of those whose disease has progressed despite optimal pharmacotherapy. The panel formulated and provided the rationale for clinical recommendations for or against interventional strategies based on this limited empirical evidence, coupled with expert opinion, to aid clinicians in the management of these complex pediatric patients. In addition, we identified important areas for future research.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu