Extracorporeal membrane oxygenation for cardiogenic shock: a meta-analysis of mortality and complications

Rajsic, Sasa; Treml, Benedikt; Jadzic, Dragana; Breitkopf, Robert; Oberleitner, Christoph; Popovic Krneta, Marina; Bukumiric, Zoran

doi:10.1186/s13613-022-01067-9

Annals of Intensive Care

Table 1 Characteristics of 32 included studies (n = 12,756)

From: Extracorporeal membrane oxygenation for cardiogenic shock: a meta-analysis of mortality and complications

Authors	Country	Study period	Prospective study	Patients	Age (years)	BMI (kg/m²)	ECMO duration (days)	Pre-ECMO cardiac arrest	Population	Patient groups	NOS
Aso et al. [21]	Japan	2010–2013	No	4658	64.8			2187	Cardiogenic shock	None^b	Good
Aubin et al. [54]	Germany	2011–2015	No	160	56		4^a	102	Refractory circulatory failure or cardiac arrest	Survivors and non-survivors	Fair
Bonacchi et al. [38]	Multicentric	2004–2018	Yes	209	67.5	25.8	5.3	13	Postcardiotomy cardiogenic shock	Survivors and non-survivors	Fair
Cakici et al. [35]	Turkey	2010–2015	No	148	56.6	25.2	5^a		Cardiogenic shock	Distal perfusion catheter and arterial side-graft technique	Good
Choi et al. [55]	Korea	2004–2018	No	253				181	AMI patients with cardiogenic shock	ECMO used before and after revascularization, and ECPR	Good
Elsharkawy et al. [56]	USA	1995–2005	No	233					Postcardiotomy patients	Survivors and non-survivors	Fair
Fux et al. [57]	Sweden	2006–2015	No	105	62^a	26.2^a	7^a	31	Refractory postcardiotomy cardiogenic shock	Survivors and non-survivors	Good
Karatolios et al. [58]	Germany	2014–2019	No	123	61.25	28.42	5.4^a	72	Cardiogenic shock due to AMI, dilated cardiomyopathy, or myocarditis	Impella and va-ECMO^c	Good
Laimoud et al. [39]	Saudi Arabia	2015–2019	No	106	40.2	26.5			Cardiogenic shock	Survivors and non-survivors	Good
Lan et al. [59]	Taiwan	1994–2008	No	607	53.8				Postcardiotomy cardiogenic shock, acute myocarditis, cardiomyopathy, AMI, and acute rejection after heart transplantation	Survivors and non-survivors	Good
Li et al. [60]	China	2011–2012	No	123	56.2		4.4		Postcardiotomy cardiogenic shock	Survivors and non-survivors	Good
Liao et al. [24]	China	2008–2019	No	179			4.8	54	Low cardiac output after open-heart surgery, AMI, cardiomyopathy, pulmonary embolism, myocarditis	Presence of lower limb ischemia	Good
Liem et al. [40]	USA	2010–2018	No	102	52		11.2		Cardiogenic shock	ECPR and cardiogenic shock^b	Fair
Loforte et al. [25]	Italy	2006–2012	No	228	58.3		10.9	29	Postcardiotomy cardiogenic shock	Postcardiotomy, donor graft failure, AMI, heart failure, myocarditis	Good
Lunz et al. [22]	Germany	2010–2016	No	223	58.1^a	26.1^a	3^a	146	Femoral Va-ECMO approach for low cardiac output, cardiac failure during coronary intervention and resuscitation	Presence of limb ischemia	Fair
Masha et al. [36]	USA	2012–2016	No	223				144	Cardiac arrest, cardiogenic shock, AMI, support of heart transplant or left ventricular assist device	Survivors and non-survivors	Good
Mazzeffi et al. [61]	USA	2010–2015	No	121					Postcardiotomy shock, other cardiogenic shock, or respiratory failure with cardiac dysfunction	ACT and aPTT	Good
McCloskey et al. [62]	USA	2000–2017	No	187	47	29.7	3.1^a		Failed weaning from CPB, AMI, refractory arrhythmia, pulmonary embolism, decompensated heart failure and others	Survivors and non-survivors	Good
Papadopoulos et al. [63]	Germany	2001–2013	No	360	62		7	50	Postcardiotomy cardiogenic shock	None	Fair
Radakovic et al. [64]	Germany	2010–2019	No	158					Postcardiotomy shock, cardiac arrest, failed weaning from CPB, refractory cardiogenic shock, right-heart failure, and left-heart failure	Central and peripheral cannulation	Good
Rastan et al. [65]	Germany	1996–2008	No	517	63.5		3.3	32	Postcardiotomy cardiogenic shock	Survivors and non-survivors	Fair
Ro et al. [66]	Korea	2005–2012	No	253	58.8		3^a	80	Cardiogenic shock	Presence of IABP	Good
Roth et al. [67]	Germany	2011–2018	No	344	59		7.6		Cardiogenic shock	Presence of thromboembolic complications	Good
Rubino et al. [37]	UK	2008–2016	No	101	57.1		5^a		Va-ECMO after cardiac surgery	Survivors and non-survivors	Good
Salna et al. [68]	USA	2008–2019	No	431	60^a	28.3^a	4.5^a	42	Postcardiotomy shock, AMI, acute decompensated heart failure, ECPR, primary graft dysfunction, unstable arrhythmia, pulmonary embolism, and others	Body mass index categories	Good
Son et al. [69]	USA	2014–2018	No	105	54.9		5.6	48	Cardiogenic shock or ECPR	Presence of acute limb ischemia	Good
Toivonen et al. [70]	Multicentric	2010–2018	No	781					Postcardiotomy cardiogenic shock	Presence of neurologic injury	Good
Vigneshwar et al. [71]	Multicentric	2013–2018	No	789	54.8	29.8	4.3^a	119	Postcardiotomy shock, cardiomyopathy, cardiac arrest, AMI, and acute rejection of heart transplant	Survivors and non-survivors	Good
Wood et al. [72]	USA	2011–2018	No	203					Cardiogenic shock, postcardiotomy shock, ECPR, acute pulmonary embolism and sepsis	Presence of anticoagulation	Good
Wu et al. [73]	Taiwan	2003–2009	No	110	60		6		Postcardiotomy cardiogenic shock	Survivors and non-survivors	Fair
Yau et al. [74]	USA	2011–2016	No	154	55		3.7^a		Patients with femoral va-ECMO	None	Good
Zhigalov et al. [23]	Germany	2009–2019	No	462	66.2	27.9	4^a	115	Cardiogenic shock or ECPR	Presence of postcardiotomy	Good

^aMedian value. NOS: Newcastle–Ottawa scale score, AMI: acute myocardial infarction, va-ECMO: venoarterial extracorporeal membrane oxygenation, ECPR: extracorporeal cardiopulmonary reanimation, CPB: cardiopulmonary bypass, ACT: activated clotting time, aPTT: activated partial thromboplastin time, IABP: intra-aortic balloon pump
^bAuthors included only the group of patients with cardiogenic shock in the analysis
^cAuthors included only the group of patients with VA-ECMO in the analysis

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