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URL: https://dx.doi.org/10.17504/protocols.io.bb3tiqnn

Authors: Hyunsuk Frank Roh, Chang-Guk Kim, Soon-Ho Chon, Jung Mogg Kim

Summary: Purpose:Time-to-event data of hazard ratios were used to generate a forest plot of all-cause mortality on extracorporeal membrane oxygenation (ECMO) in both overall and individual indications of cardiopulmonary disease in adults.Materials and Methods:A systemic search was conducted in PubMed from 1975 to 2018. Among 4,121 articles, a total of 34 clinical reports comprising 20,610patients (1,631 of the patients who underwent ECMO and 18,979 of the patients who did not undergo ECMO) met the inclusion criteria.Results:The pooled hazard ratio of 1.2828 (95% confidence interval: 0.9649, 1.7054) suggests that the ECMO group was not significantly associated with a reduction in mortality compared with the no-ECMO group in the overall ECMO indications. The results of subgroup analyses showed a significantly improved patient survival in respiratory failure with 0.6308 (0.5037, 0.7900), and a worse patient survival after lung transplantation with 2.0600 (1.6987, 2.4981), in bridging to heart transplantation with 1.4212 (1.0309, 1.9592), and after heart transplantation with 5.6365 (1.7569, 18.0827).Conclusions:Most of the included studies are retrospective, which diminishes the significance of the findings due to a higher risk of selection bias, which was exemplified by the allocation of ECMO based on the patients’ severity condition.

Affiliations: Emergency Medicine and Echocardiography Laboratory, Dongjak Kyunghee Hospital, Seoul, Korea. nGene Hemodynamic Research Center, Seoul, Korea., Department of Medicine, Hanyang University College of Medicine, Seoul, Korea., Department of Thoracic and Cardiovascular Surgery, Hando General Hospital, Ansan City, Gyunggi, Korea., Department of Microbiology and Biomedical Science, Hanyang University College of Medicine and Graduate School of Biomedical Science and Engineering, Seoul, Korea.

Version: 1

Publication Date: 2020

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