Guidelines for anaesthesia of adults with congenital heart disease in non-cardiac surgery

IF 3.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-04-29 DOI:10.1016/j.accpm.2025.101540

Nadir Tafer , Elise Langouet , Xavier Alacoque , Pascal Amedro , Miréla Bojan , Marie Bruyère , Bernard Cholley , Catherine Koffel , Magalie Ladouceur , Stéphane Lebel , Bertrand Leobon , Loïc Mace , Estelle Morau , Caroline Ovaert , Jean-Benoît Thambo , Diane Zotnik , Hugues de Courson , Marc-Olivier Fischer

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引用次数: 0

Abstract

Objective

To provide guidelines for the anesthetic management of adults with congenital heart disease for non-cardiac surgery.

Design

A consensus committee of 16 experts was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding (i.e., pharmaceutical, medical devices). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE®) system to guide the assessment of the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized.

Methods

The committee studied 10 questions within 4 fields: preoperative evaluation, intraoperative management, postoperative care, and obstetrics. Each question was formulated in a PICO (Patients Intervention Comparison Outcome) format and evidence profiles were produced. The literature review and recommendations were made according to the GRADE® methodology.

Results

The experts' synthesis work and the application of the GRADE® method resulted in 11 expert opinions. Some of the questions did not find any response in the literature. After one round of scoring, a strong agreement was reached for all recommendations.

Conclusions

There was strong agreement among experts for 10 recommendations to improve practices for the anesthetic management of adults with congenital heart disease for non-cardiac surgery.

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成人先天性心脏病非心脏手术麻醉指南。

目的：为成人先天性心脏病非心脏手术的麻醉处理提供指导。设计：召集了一个由16位专家组成的共识委员会。在流程开始时制定了正式的利益冲突（COI）政策，并在整个过程中执行。整个准则过程是独立于任何工业资金（即制药、医疗设备）进行的。作者被要求遵循建议评估、发展和评价分级（GRADE®）系统的规则来指导证据质量的评估。强调了在低质量证据面前提出强烈建议的潜在弊端。方法：委员会研究了术前评价、术中管理、术后护理、产科4个领域的10个问题。每个问题都以PICO（患者干预比较结果）格式制定，并产生证据概况。根据GRADE®方法进行文献综述和建议。结果：通过专家的综合工作和GRADE®方法的应用，得出了11条专家意见。有些问题在文献中没有找到任何答案。经过一轮评分，所有的建议都达成了强烈的一致。结论：专家们强烈同意10项建议，以改进成人先天性心脏病非心脏手术的麻醉管理实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

期刊介绍： Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.