Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis

التفاصيل البيبلوغرافية
العنوان: Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis
المؤلفون: Jasper V. Schotborgh, José P.S. Henriques, Krischan D. Sjauw, Antoine H.G. Driessen, Wim K. Lagrand, Thomas G. V. Cherpanath, Bas A.J.M. de Mol, Jacqueline Limpens, Dagmar M. Ouweneel, Annemarie E. Engström
المصدر: Intensive Care Medicine. 42:1922-1934
بيانات النشر: Springer Science and Business Media LLC, 2016.
سنة النشر: 2016
مصطلحات موضوعية: Male, endocrine system, medicine.medical_specialty, medicine.medical_treatment, Shock, Cardiogenic, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Extracorporeal, Pulmonary function testing, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Internal medicine, Anesthesiology, Extracorporeal membrane oxygenation, medicine, Humans, Cardiopulmonary resuscitation, Myocardial infarction, Retrospective Studies, business.industry, Cardiogenic shock, 030208 emergency & critical care medicine, medicine.disease, Heart Arrest, Treatment Outcome, Editorial, Life support, cardiovascular system, Cardiology, Female, business
الوصف: Veno-arterial extracorporeal life support (ECLS) is increasingly used in patients during cardiac arrest and cardiogenic shock, to support both cardiac and pulmonary function. We performed a systematic review and meta-analysis of cohort studies comparing mortality in patients treated with and without ECLS support in the setting of refractory cardiac arrest and cardiogenic shock complicating acute myocardial infarction. We systematically searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the publisher subset of PubMed updated to December 2015. Thirteen studies were included of which nine included cardiac arrest patients (n = 3098) and four included patients with cardiogenic shock after acute myocardial infarction (n = 235). Data were pooled by a Mantel-Haenzel random effects model and heterogeneity was examined by the I (2) statistic. In cardiac arrest, the use of ECLS was associated with an absolute increase of 30 days survival of 13 % compared with patients in which ECLS was not used [95 % CI 6-20 %; p < 0.001; number needed to treat (NNT) 7.7] and a higher rate of favourable neurological outcome at 30 days (absolute risk difference 14 %; 95 % CI 7-20 %; p < 0.0001; NNT 7.1). Propensity matched analysis, including 5 studies and 438 patients (219 in both groups), showed similar results. In cardiogenic shock, ECLS showed a 33 % higher 30-day survival compared with IABP (95 % CI, 14-52 %; p < 0.001; NNT 13) but no difference when compared with TandemHeart/Impella (-3 %; 95 % CI -21 to 14 %; p = 0.70; NNH 33). In cardiac arrest, the use of ECLS was associated with an increased survival rate as well as an increase in favourable neurological outcome. In the setting of cardiogenic shock there was an increased survival with ECLS compared with IABP
تدمد: 1432-1238
0342-4642
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::284c95e3b1fa22c7016d21dfa380b0b5
https://doi.org/10.1007/s00134-016-4536-8
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....284c95e3b1fa22c7016d21dfa380b0b5
قاعدة البيانات: OpenAIRE