Does extracorporeal cardiopulmonary resuscitation improve survival with favorable neurological outcome in out-of-hospital cardiac arrest? A systematic review and meta-analysis.
J Crit Care
; 84: 154882, 2024 Dec.
Article
em En
| MEDLINE
| ID: mdl-39053234
ABSTRACT
PURPOSE:
Extracorporeal cardiopulmonary resuscitation (E-CPR) may improve survival with favorable neurological outcome in patients with refractory out-of-hospital cardiac arrest (OHCA). Unfortunately, recent results from randomized controlled trials were inconclusive. We performed a meta-analysis to investigate the impact of E-CPR on neurological outcome compared to conventional cardiopulmonary resuscitation (C-CPR).METHODS:
A systematic research for articles assessing outcomes of adult patients with OHCA either treated with E-CPR or C-CPR up to April 27, 2023 was performed. Primary outcome was survival with favorable neurological outcome at discharge or 30 days. Overall survival was also assessed.RESULTS:
Eighteen studies were included. E-CPR was associated with better survival with favorable neurological status at discharge or 30 days (14% vs 7%, OR 2.35, 95% CI 1.61-3.43, I2 = 80%, p < 0.001, NNT = 17) than C-CPR. Results were consistent if the analysis was restricted to RCTs. Overall survival to discharge or 30 days was also positively affected by treatment with E-CPR (OR = 1.71, 95% CI = 1.18-2.46, I2 = 81%, p = 0.004, NNT = 11).CONCLUSIONS:
In this meta-analysis, E-CPR had a positive effect on survival with favorable neurological outcome and, to a smaller extent, on overall mortality in patients with refractory OHCA.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Oxigenação por Membrana Extracorpórea
/
Reanimação Cardiopulmonar
/
Parada Cardíaca Extra-Hospitalar
Limite:
Humans
Idioma:
En
Revista:
J Crit Care
/
J. crit. care
/
Journal of critical care
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Itália