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World Journal of Emergency Medicine ›› 2017, Vol. 8 ›› Issue (1): 5-11.doi: 10.5847/wjem.j.1920-8642.2017.01.001

• Original Articles •     Next Articles

Comparison of extracorporeal and conventional cardiopulmonary resuscitation: A meta-analysis of 2 260 patients with cardiac arrest

Gan-nan Wang, Xu-feng Chen, Li Qiao, Yong Mei, Jin-ru Lv, Xi-hua Huang, Bin Shen, Jin-song Zhang()   

  1. Department of Emergency Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
  • Received:2016-08-06 Accepted:2017-01-20 Online:2017-03-15 Published:2017-03-15
  • Contact: Jin-song Zhang E-mail:wanggnhua@163.com

Abstract:

BACKGROUND: This meta-analysis aimed to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients with cardiac arrest (CA).

DATA RESOURCES: PubMed, EMBASE, Web of Science, and China Biological Medicine Database were searched for relevant articles. The baseline information and outcome data (survival, good neurological outcome at discharge, at 3-6 months, and at 1 year after CA) were collected and extracted by two authors. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using Review Manager 5.3.

RESULTS: In six studies 2 260 patients were enrolled to study the survival rate to discharge and long-term neurological outcome published since 2000. A significant effect of ECPR was observed on survival rate to discharge compared to CCPR in CA patients (RR 2.37, 95%CI 1.63-3.45, P<0.001), and patients who underwent ECPR had a better long-term neurological outcome than those who received CCPR (RR 2.79, 95%CI 1.96-3.97, P<0.001). In subgroup analysis, there was a significant difference in survival to discharge favoring ECPR over CCPR group in OHCA patients (RR 2.69, 95%CI 1.48-4.91, P=0.001). However, no significant difference was found in IHCA patients (RR 1.84, 95%CI 0.91-3.73, P=0.09).

CONCLUSION: ECPR showed a beneficial effect on survival rate to discharge and long-term neurological outcome over CCPR in adult patients with CA.

Key words: Extracorporeal cardiopulmonary resuscitation, Cardiac arrest, Adult, Outcome, Meta-analysis