Management of Paediatric Ulcerative Colitis, Part 2: Acute Severe Colitis-An Evidence-based Consensus Guideline From the European Crohn's and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition
Por:
Turner D, Ruemmele FM, Orlanski-Meyer E, Griffiths AM, Martín-de-Carpi J, Bronsky J, Veres G, Aloi M, Strisciuglio C, Braegger CP, Assa A, Romano C, Hussey S, Stanton M, Pakarinen M, de Ridder L, Katsanos KH, Croft N, Navas-López VM, Wilson DC, Lawrence S and Russell RK
Publicada:
1 ago 2018
Ahead of Print:
30 may 2018
Resumen:
Background and aim: Acute severe colitis (ASC) is one of the few emergencies in pediatric gastroenterology. Tight monitoring and timely medical and surgical interventions may improve outcomes and minimize morbidity and mortality. We aimed to standardize daily treatment of ASC in children through detailed recommendations and practice points which are based on a systematic review of the literature and consensus of experts.
Methods: These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Fifteen predefined questions were addressed by working subgroups. An iterative consensus process, including 2 face-to-face meetings, was followed by voting of the national representatives of ECCO and all members of the Paediatric Inflammatory Bowel Disease (IBD) Porto group of ESPGHAN (43 voting experts).
Results: A total of 24 recommendations and 43 practice points were endorsed with a consensus rate of at least 91% regarding diagnosis, monitoring, and management of ASC in children. A summary flowchart is presented based on daily scoring of the Paediatric Ulcerative Colitis Activity Index. Several topics have been altered since the previous 2011 guidelines and from those published in adults.
Discussion: These guidelines standardize the management of ASC in children in an attempt to optimize outcomes of this intensive clinical scenario.
Filiaciones:
Turner D:
Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel
Ruemmele FM:
Université Paris Descartes, Sorbonne Paris Cité, APHP, Hôpital Necker Enfants Malades, Paris, France
Orlanski-Meyer E:
Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel
Griffiths AM:
The Hospital for Sick Children, University of Toronto, Canada
Martín-de-Carpi J:
Hospital Sant Joan de Déu, Barcelona, Spain
Bronsky J:
Department of Paediatrics, University Hospital Motol, Prague, Czech Republic
Veres G:
Ist Department of Pediatrics, Semmelweis University, Budapest, Hungary
Aloi M:
Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy
Strisciuglio C:
Department of Woman, Child and General and Specialistic Surgery, University of Campania Luigi Vanvitelli, Napoli, Italy
Braegger CP:
University Children's Hospital, Zurich, Switzerland
Assa A:
Schneider Children's Hospital, Petach Tikva, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
Romano C:
Pediatric Department, University of Messina, Italy
Hussey S:
National Children's Research Centre, Royal College of Surgeons of Ireland and University College Dublin, Ireland
Stanton M:
Southampton Children's Hospital, UK
Pakarinen M:
Helsinki University Children's Hospital, Department of Pediatric Surgery, Helsinki, Finland
de Ridder L:
Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
Katsanos KH:
Medical School and University Hospital of Ioannina, Greece
Croft N:
Barts and the London School of Medicine, Queen Mary University of London, UK
Navas-López VM:
Pediatric Gastroenterology and Nutrition Unit. Hospital Materno. IBIMA. Málaga, Spain
Wilson DC:
Child Life and Health, University of Edinburgh, UK
Lawrence S:
BC Children's Hospital, University of British Columbia, Vancouver BC, Canada
Russell RK:
The Royal Hospital for Children, Glasgow, UK
Green Published, Green Submitted, Green Accepted
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