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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...

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Autores principales: Alfalasi, Reem, Downing, Jessica, Cardona, Stephanie, Lowie, Bobbi-Jo, Fairchild, Matthew, Chan, Caleb, Powell, Elizabeth, Pourmand, Ali, Grazioli, Alison, Tran, Quincy K.
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
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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.
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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
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