Clinical Medicine
Effect of extracorporeal membrane oxygenation on critical patients with non-pulmonary primary disease in the emergency department: a meta-analysis
Lan Chao, Lyu Qing, Liu Qi, Pei Hui, Meng Xing, Luo Zhiyi, Wang Chao, Ye Huaqing, Shan Mengtian, Xu Nengyuan
Published 2018-09-10
Cite as Chin J Emerg Med, 2018, 27(9): 1019-1025. DOI: 10.3760/cma.j.issn.1671-0282.2018.09.013
Abstract
ObjectiveTo investigate the effect of extracorporeal membrane oxygenation (ECMO) on critical patients with non-pulmonary primary disease in the emergency department.
MethodsThe literature of English and Chinese clinical studies on the ECMO treating critical patients with non-pulmonary primary disease published before August 2017 were electronically searched on PubMed, Embase and other databases. The obtained articles were selected, their qualities were strictly evaluated, and the in-hospital survival rate, 3-month, 6-month and 1-year survival rate, as well as the average intensive care unit (ICU) and length of hospital stay were extracted. This meta-analysis were performed using RevMan software (Version 5.0, Cochrane collaboration).
ResultsA total of 11 articles (n=3 043) were enrolled including 616 cases of ECMO treatment group and 2 427 cases of control group. Fitting results showed that compared with the traditional treatment, application of ECMO can improve the in-hospital survival rate[52.1%(321/616) vs. 32.1% (780/2 427); OR=2.02; 95%CI:1.11-3.67, P=0.02] and the survival rate more than 90 days[42.1% (61/145) vs. 17.1% (38/222); OR=3.98; 95%CI:2.30-6.89, P<0.01]; and prolong the average length of hospital stay (MD=-5.35, 95%CI:-8.10--2.60, P<0.01) and ICU time (MD=-8.99, 95%CI:-8.20--1.80, P<0.01).
ConclusionsMeta-analysis of existing studies showed that application of ECMO can improve the short-term and long-term prognosis of critical patients with non-pulmonary primary disease. However, due to the small number of studies and the large heterogeneity of the study population, it is necessary to carry out more, large samples and high quality randomized controlled clinical trials.
Key words:
Extracorporeal membrane oxygenation; Poisoning; Cardiac arrest; Arrhythmia; Emergency critical disease; Meta analysis
Contributor Information
Lan Chao
Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Lyu Qing
Liu Qi
Pei Hui
Meng Xing
Luo Zhiyi
Wang Chao
Ye Huaqing
Shan Mengtian
Xu Nengyuan