Shannon Gui1, Nimita Patel2, Robert Issenman3, April J Kam4. 1. Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. 2. Faculty of Science, Department of Life Sciences, McMaster University, Hamilton, Ontario, Canada. 3. Department of Pediatrics, Division of Pediatric Gastroenterology, McMaster Children's Hospital, Hamilton, Ontario, Canada. 4. Department of Pediatrics, Division of Emergency Medicine, McMaster Children's Hospital, Hamilton, Ontario, Canada. Electronic address: kama@mcmaster.ca.
Abstract
OBJECTIVES: To synthesize quantitative and qualitative data on pharmacologic interventions of pediatric cyclic vomiting syndrome and their effectiveness in disease management in the acute care setting. STUDY DESIGN: Using keywords, 799 studies published up from December 1954 to February 2018 were extracted from MEDLINE via Pubmed, Embase via OVID, CINAHL via EBSCO, and Cochrane Controlled Trials Registry. Studies were evaluated for inclusion and exclusion by 2 independent reviewers using predetermined inclusion and exclusion criteria. RESULTS: The search yielded 84 studies for full review, of which 54 were included in the systematic review. Studies were subsequently separated into 1 group of 6 case series studies containing quantitative data on sumatriptan, ondansetron, phenothiazines, prokinetic agents, carbohydrate, isometheptene, and aprepitant; 1 one group consisting only of qualitative studies containing expert recommendations. CONCLUSIONS: Ondansetron has the most quantitative and qualitative evidence to support its inclusion in pediatric emergency department protocols as a rescue therapy. Sumatriptan and aprepitant are potential candidates for inclusion as abortive therapies. Qualitative data from retrospective studies and case reports are not applicable to a larger patient population. This report informs a need for controlled, prospective cohort studies and randomized, controlled trials to optimize current management protocols and to develop new medical interventions.
OBJECTIVES: To synthesize quantitative and qualitative data on pharmacologic interventions of pediatric cyclic vomiting syndrome and their effectiveness in disease management in the acute care setting. STUDY DESIGN: Using keywords, 799 studies published up from December 1954 to February 2018 were extracted from MEDLINE via Pubmed, Embase via OVID, CINAHL via EBSCO, and Cochrane Controlled Trials Registry. Studies were evaluated for inclusion and exclusion by 2 independent reviewers using predetermined inclusion and exclusion criteria. RESULTS: The search yielded 84 studies for full review, of which 54 were included in the systematic review. Studies were subsequently separated into 1 group of 6 case series studies containing quantitative data on sumatriptan, ondansetron, phenothiazines, prokinetic agents, carbohydrate, isometheptene, and aprepitant; 1 one group consisting only of qualitative studies containing expert recommendations. CONCLUSIONS:Ondansetron has the most quantitative and qualitative evidence to support its inclusion in pediatric emergency department protocols as a rescue therapy. Sumatriptan and aprepitant are potential candidates for inclusion as abortive therapies. Qualitative data from retrospective studies and case reports are not applicable to a larger patient population. This report informs a need for controlled, prospective cohort studies and randomized, controlled trials to optimize current management protocols and to develop new medical interventions.
Authors: Giovanni Prezioso; Agnese Suppiej; Valentina Alberghini; Patrizia Bergonzini; Maria Elena Capra; Ilaria Corsini; Alessandro De Fanti; Elisa Fiumana; Martina Fornaro; Lucia Marangio; Paolo Ricciardelli; Laura Serra; Duccio Maria Cordelli; Susanna Esposito Journal: Life (Basel) Date: 2022-01-19