Australian Clinical Consensus Guideline: The diagnosis and acute management of childhood stroke

Author:

Medley Tanya L12ORCID,Miteff Christina3,Andrews Ian4ORCID,Ware Tyson5,Cheung Michael126,Monagle Paul127,Mandelstam Simone127,Wray Alison27,Pridmore Clair8,Troedson Christopher9,Dale Russell C10ORCID,Fahey Michael11,Sinclair Adriane12,Walsh Peter13,Stojanovski Belinda17,Mackay Mark T1214

Affiliation:

1. Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia

2. Department of Paediatrics University of Melbourne, Melbourne, Australia

3. John Hunter Children's Hospital, Sydney, Australia

4. Sydney Children's Hospital, School of Women's and Children's Health, University of New South Wales, Sydney, Australia

5. Royal Hobart Hospital, Hobart, Australia

6. Department of Cardiology Royal Children's Hospital, Melbourne, Australia

7. Royal Children's Hospital, Melbourne, Australia

8. Women's and Children's Hospital. Adelaide, Australia

9. Children's Hospital at Westmead, Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia

10. Children's Hospital at Westmead and University of Sydney, Sydney Australia

11. Department of Paediatrics Monash University, Department of Medicine Melbourne University, and Monash Children's Hospital, Melbourne, Australia

12. Lady Cilento Children's Hospital, University of Queensland, Brisbane, Australia

13. Perth Children's Hospital, Perth, Australia

14. Department of Neurology Royal Children's Hospital, Melbourne Australia

Abstract

Stroke is among the top 10 causes of death in children and survivors carry resulting disabilities for decades, at substantial cost to themselves and their families. Children are not currently able to access reperfusion therapies, due to limited evidence supporting safety and efficacy and long diagnostic delays. The Australian Clinical Consensus Guideline for the Diagnosis and Acute Management of Childhood Stroke was developed to minimize unwarranted variations in care and document best evidence on the risk factors, etiologies, and conditions mimicking stroke that differ from adults. Clinical questions were formulated to inform systematic database searches from 2007 to 2017, limited to English and pediatric studies. SIGN methodology and the National Health and Medical Research Council system were used to screen and classify the evidence. The Grades of Recommendation, Assessment, Development, and Evaluation system (GRADE) was used to grade evidence as strong or weak. The Guideline provides more than 60 evidence-based recommendations to assist prehospital and acute care clinicians in the rapid identification of childhood stroke, choice of initial investigation, to confirm diagnosis, determine etiology, selection of the most appropriate interventions to salvage brain at risk, and prevent recurrence. Recommendations include advice regarding the management of intracranial pressure and congenital heart disease. Implementation of the Guideline will require reorganization of prehospital and emergency care systems, including the development of regional stroke networks, pediatric Code Stroke, rapid magnetic resonance imaging and accreditation of primary pediatric stroke centers with the capacity to offer reperfusion therapies. The Guideline will allow auditing to benchmark timelines of care, access to acute interventions, and outcomes. It will also facilitate the development of an Australian childhood stroke registry, with data linkage to international registries, to allow for accurate data collection on stroke incidence, treatment, and outcomes.

Funder

Ian Potter Foundation

Publisher

SAGE Publications

Subject

Neurology

Cited by 73 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3