Cargando…
A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis
There is limited evidence comparing the use of extracorporeal cardiopulmonary resuscitation (ECPR) to CPR in the management of refractory out-of-hospital cardiac arrest (OHCA). We conducted a systematic review and meta-analysis to compare survival and neurologic outcomes associated with ECPR versus...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955421/ https://www.ncbi.nlm.nih.gov/pubmed/35327068 http://dx.doi.org/10.3390/healthcare10030591 |
_version_ | 1784676331897749504 |
---|---|
author | Alfalasi, Reem Downing, Jessica Cardona, Stephanie Lowie, Bobbi-Jo Fairchild, Matthew Chan, Caleb Powell, Elizabeth Pourmand, Ali Grazioli, Alison Tran, Quincy K. |
author_facet | Alfalasi, Reem Downing, Jessica Cardona, Stephanie Lowie, Bobbi-Jo Fairchild, Matthew Chan, Caleb Powell, Elizabeth Pourmand, Ali Grazioli, Alison Tran, Quincy K. |
author_sort | Alfalasi, Reem |
collection | PubMed |
description | There is limited evidence comparing the use of extracorporeal cardiopulmonary resuscitation (ECPR) to CPR in the management of refractory out-of-hospital cardiac arrest (OHCA). We conducted a systematic review and meta-analysis to compare survival and neurologic outcomes associated with ECPR versus CPR in the management of OHCA. We searched PubMed, EMBASE, and Scopus to identify observational studies and randomized controlled trials comparing ECPR and CPR. We used the Newcastle–Ottawa Scale and Cochrane’s risk-of-bias tool to assess studies’ quality. We used random-effects models to compare outcomes between the pooled populations and moderator analysis to identify sources of heterogeneity and perform subgroup analysis. We identified 2088 articles and included 13, with 18,620 patients with OHCA. A total of 16,701 received CPR and 1919 received ECPR. Compared with CPR, ECPR was associated with higher odds of achieving favorable neurologic outcomes at 3 (OR 5, 95% CI 1.90–13.1, p < 0.01) and 6 months (OR 4.44, 95% CI 2.3–8.5, p < 0.01). We did not find a significant survival benefit or impact on neurologic outcomes at hospital discharge or 1 month following arrest. ECPR is a promising but resource-intensive intervention with the potential to improve long-term outcomes among patients with OHCA. |
format | Online Article Text |
id | pubmed-8955421 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89554212022-03-26 A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis Alfalasi, Reem Downing, Jessica Cardona, Stephanie Lowie, Bobbi-Jo Fairchild, Matthew Chan, Caleb Powell, Elizabeth Pourmand, Ali Grazioli, Alison Tran, Quincy K. Healthcare (Basel) Review There is limited evidence comparing the use of extracorporeal cardiopulmonary resuscitation (ECPR) to CPR in the management of refractory out-of-hospital cardiac arrest (OHCA). We conducted a systematic review and meta-analysis to compare survival and neurologic outcomes associated with ECPR versus CPR in the management of OHCA. We searched PubMed, EMBASE, and Scopus to identify observational studies and randomized controlled trials comparing ECPR and CPR. We used the Newcastle–Ottawa Scale and Cochrane’s risk-of-bias tool to assess studies’ quality. We used random-effects models to compare outcomes between the pooled populations and moderator analysis to identify sources of heterogeneity and perform subgroup analysis. We identified 2088 articles and included 13, with 18,620 patients with OHCA. A total of 16,701 received CPR and 1919 received ECPR. Compared with CPR, ECPR was associated with higher odds of achieving favorable neurologic outcomes at 3 (OR 5, 95% CI 1.90–13.1, p < 0.01) and 6 months (OR 4.44, 95% CI 2.3–8.5, p < 0.01). We did not find a significant survival benefit or impact on neurologic outcomes at hospital discharge or 1 month following arrest. ECPR is a promising but resource-intensive intervention with the potential to improve long-term outcomes among patients with OHCA. MDPI 2022-03-21 /pmc/articles/PMC8955421/ /pubmed/35327068 http://dx.doi.org/10.3390/healthcare10030591 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Alfalasi, Reem Downing, Jessica Cardona, Stephanie Lowie, Bobbi-Jo Fairchild, Matthew Chan, Caleb Powell, Elizabeth Pourmand, Ali Grazioli, Alison Tran, Quincy K. A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis |
title | A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis |
title_full | A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis |
title_fullStr | A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis |
title_full_unstemmed | A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis |
title_short | A Comparison between Conventional and Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis |
title_sort | comparison between conventional and extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955421/ https://www.ncbi.nlm.nih.gov/pubmed/35327068 http://dx.doi.org/10.3390/healthcare10030591 |
work_keys_str_mv | AT alfalasireem acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT downingjessica acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT cardonastephanie acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT lowiebobbijo acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT fairchildmatthew acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT chancaleb acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT powellelizabeth acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT pourmandali acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT graziolialison acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT tranquincyk acomparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT alfalasireem comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT downingjessica comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT cardonastephanie comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT lowiebobbijo comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT fairchildmatthew comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT chancaleb comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT powellelizabeth comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT pourmandali comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT graziolialison comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis AT tranquincyk comparisonbetweenconventionalandextracorporealcardiopulmonaryresuscitationinoutofhospitalcardiacarrestasystematicreviewandmetaanalysis |