Ashley R Wilson-Smith1,2, Yulia Bogdanova2, Stephanie Roydhouse2, Kevin Phan1, David H Tian1,3, Tristan D Yan1,4, Antonio Loforte5. 1. The Collaborative Research Group (CORE), Macquarie University, Sydney, Australia. 2. The University of New South Wales, Faculty of Medicine, Sydney, Australia. 3. Royal North Shore Hospital, Sydney, Australia. 4. Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital (RPA), Camperdown, Australia. 5. Department of Cardiovascular Surgery and Transplantation, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Abstract
BACKGROUND: Despite advances in management techniques and medical therapy, refractory cardiogenic shock remains a life-threatening condition with high mortality rates. The present systematic review and meta-analysis aims to explore the outcomes associated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) use in the setting of refractory cardiogenic shock, stratified per survivorship. METHODS: A literature search was performed using three electronic databases from the date of their inception up to June 2018. The literature search and subsequent data extraction were performed by two independent reviewers. Digitized survival data were extracted from Kaplan-Meier curves in order to re-create the original patient data using an iterative algorithm and were subsequently aggregated for analysis. RESULTS: Fifty-two studies were included, with 44 undergoing quantitative analysis. A total of 17,515 patients were identified, with a mean age of 58.4±9.4 years and a mean duration of ECMO support of 5.1±2.6 days; 68.7% of the patients were male. Aggregated survival rates at 1, 2, 3 and 5 years were 36.7%, 34.8%, 33.8% and 29.9%, respectively. CONCLUSIONS: The present systematic review illustrates the expected survival results for VA-ECMO in the intermediate- to long-term. Extended follow-up and standardized reporting measures are urgently needed in order to carry out more definitive subgroup analyses.
BACKGROUND: Despite advances in management techniques and medical therapy, refractory cardiogenic shock remains a life-threatening condition with high mortality rates. The present systematic review and meta-analysis aims to explore the outcomes associated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) use in the setting of refractory cardiogenic shock, stratified per survivorship. METHODS: A literature search was performed using three electronic databases from the date of their inception up to June 2018. The literature search and subsequent data extraction were performed by two independent reviewers. Digitized survival data were extracted from Kaplan-Meier curves in order to re-create the original patient data using an iterative algorithm and were subsequently aggregated for analysis. RESULTS: Fifty-two studies were included, with 44 undergoing quantitative analysis. A total of 17,515 patients were identified, with a mean age of 58.4±9.4 years and a mean duration of ECMO support of 5.1±2.6 days; 68.7% of the patients were male. Aggregated survival rates at 1, 2, 3 and 5 years were 36.7%, 34.8%, 33.8% and 29.9%, respectively. CONCLUSIONS: The present systematic review illustrates the expected survival results for VA-ECMO in the intermediate- to long-term. Extended follow-up and standardized reporting measures are urgently needed in order to carry out more definitive subgroup analyses.
Authors: Antonio Loforte; Giuseppe Marinelli; Francesco Musumeci; Gianluca Folesani; Emanuele Pilato; Sofia Martin Suarez; Andrea Montalto; Paola Lilla Della Monica; Francesco Grigioni; Guido Frascaroli; Antonio Menichetti; Roberto Di Bartolomeo; Giorgio Arpesella Journal: Artif Organs Date: 2014-05-20 Impact factor: 3.094
Authors: Antonio Loforte; Andrea Montalto; Federico Ranocchi; Paola Lilla Della Monica; Giovanni Casali; Angela Lappa; Antonio Menichetti; Carlo Contento; Francesco Musumeci Journal: Artif Organs Date: 2012-02-21 Impact factor: 3.094
Authors: Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher Journal: BMJ Date: 2009-07-21
Authors: Giles J Peek; Miranda Mugford; Ravindranath Tiruvoipati; Andrew Wilson; Elizabeth Allen; Mariamma M Thalanany; Clare L Hibbert; Ann Truesdale; Felicity Clemens; Nicola Cooper; Richard K Firmin; Diana Elbourne Journal: Lancet Date: 2009-09-15 Impact factor: 79.321
Authors: Alexander M Bernhardt; Benedikt Schrage; Ines Schroeder; Georg Trummer; Dirk Westermann; Hermann Reichenspurner Journal: Dtsch Arztebl Int Date: 2022-04-01 Impact factor: 8.251
Authors: Mariusz Kowalewski; Pietro Giorgio Malvindi; Kamil Zieliński; Gennaro Martucci; Artur Słomka; Piotr Suwalski; Roberto Lorusso; Paolo Meani; Antonio Arcadipane; Michele Pilato; Giuseppe Maria Raffa Journal: J Clin Med Date: 2020-04-07 Impact factor: 4.241
Authors: Mihai Stefan; Ovidiu Stiru; Ioana Marinica; Mihail Luchian; Alina Paunescu; Alexandra Ciurciun; Vlad Anton Iliescu; Ovidiu Chioncel; Serban Bubenek; Daniela Filipescu Journal: Rom J Anaesth Intensive Care Date: 2020-12-31
Authors: Sebastian D Sahli; Alexander Kaserer; Donat R Spahn; Markus J Wilhelm; Julia Braun; Maximilian Halbe; Yuliya Dahlem; Muriel A Spahn; Julian Rössler; Bernard Krüger; Francesco Maisano Journal: J Thorac Dis Date: 2022-06 Impact factor: 3.005
Authors: Sasa Rajsic; Benedikt Treml; Dragana Jadzic; Robert Breitkopf; Christoph Oberleitner; Marina Popovic Krneta; Zoran Bukumiric Journal: Ann Intensive Care Date: 2022-10-05 Impact factor: 10.318
Authors: Mir B Basir; Duane S Pinto; Boback Ziaeian; Akshay Khandelwal; Jennifer Cowger; William Suh; Andrew Althouse Journal: Catheter Cardiovasc Interv Date: 2021-03-07 Impact factor: 2.692