• Am J Emerg Med · Jan 2022

    Meta Analysis

    How effective is extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest? A systematic review and meta-analysis.

    • Jessica Downing, Reem Al Falasi, Stephanie Cardona, Matthew Fairchild, Bobbi Lowie, Caleb Chan, Elizabeth Powell, Ali Pourmand, and Quincy K Tran.
    • Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: jvdowning@som.umaryland.edu.
    • Am J Emerg Med. 2022 Jan 1; 51: 127-138.

    BackgroundExtracorporeal cardiopulmonary resuscitation (ECPR) has gained increasing as a promising but resource-intensive intervention for out-of-hospital cardiac arrest (OHCA). There is little data to quantify the impact of this intervention and the patients likely to benefit from its use. We conducted a meta-analysis of the literature to assess the survival benefit associated with ECPR for OHCA.MethodsWe searched PubMed, Embase, and Scopus databases to identify relevant observational studies and randomized control trials. We used the Newcastle-Ottawa Scale and Cochrane risk-of-bias tool to assess studies' quality. We performed random-effects meta-analysis for the primary outcome of survival to hospital discharge and used meta-regressions to assess heterogeneity.ResultsWe identified 1287 articles, reviewed the full text of 209 and included 44 in our meta-analysis. Our analysis included 3097 patients with OHCA. Patients' mean age was 52, 79% were male, and 60% had primary ventricular fibrillation/ventricular tachycardia arrest. We identified a survival-to-discharge rate of 24%; 18% survived with favorable neurologic function. 30- and 90-days survival rates were both around 18%. The majority of included articles were high quality studies.ConclusionsExtracorporeal cardiopulmonary resuscitation is a promising but resource-intensive intervention that may increase rates of survival to hospital discharge among patients who experience OHCA.Copyright © 2021. Published by Elsevier Inc.

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