• Xiaoying Yang, Min Xiang, Lifang Wu, Meng He, and Hongyan Zhu.
• Xiaoying Yang, Pulmonary and Critical Care Medicine Dept., Shaoxing People's Hospital, Shaoxing, Zhejiang Province312000, P.R. China.
• Pak J Med Sci. 2025 Jan 1; 41 (1): 312317312-317.

ObjectiveThe survival benefit of venoarterial Extracorporeal Membrane Oxygenation (ECMO) for the management of acute high-risk pulmonary embolism (PE) remains unclear. This meta-analysis combines data from comparative studies to assess the risk of mortality after ECMO vs standard care in the management of acute high-risk PE.MethodsDatabases of PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched from 01st January 2000 to 24th March 2023 for comparative studies with at least 10 patients/group comparing ECMO vs standard treatment. PRISMA guidelines were followed for this review. We extracted mortality data and combined it to obtain the outcome as risk ratios (RR) with 95% confidence intervals (CI) in a random-effects model.ResultsTen studies were included. Meta-analysis showed that the risk of early mortality was not significantly different between ECMO and non-ECMO groups (RR: 0.97 95% CI: 0.78, 1.19 I2=73%). No change in significance was noted on subgroup analysis based on study location, sample size, cardiac arrest, systemic thrombolysis, and surgical embolectomy.ConclusionLimited evidence derived from mostly retrospective studies riddled with selection bias suggests that ECMO may not offer additional survival benefits in high-risk PE.Copyright: © Pakistan Journal of Medical Sciences.

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