التفاصيل البيبلوغرافية
| العنوان: |
Efficacy and safety of extracorporeal membrane oxygenation for high-risk pulmonary embolism: A systematic review and meta-analysis. |
| المؤلفون: |
Pozzi, Matteo, Metge, Augustin, Martelin, Anthony, Giroudon, Caroline, Lanier Demma, Justine, Koffel, Catherine, Fornier, William, Chiari, Pascal, Fellahi, Jean Luc, Obadia, Jean Francois, Armoiry, Xavier |
| المصدر: |
Vascular Medicine; Oct2020, Vol. 25 Issue 5, p460-467, 8p |
| مصطلحات موضوعية: |
EXTRACORPOREAL membrane oxygenation, PULMONARY embolism, META-analysis, LEG, DATABASE searching |
| مستخلص: |
High-risk pulmonary embolism (PE) requires hemodynamic and respiratory support along with reperfusion strategies. Recently updated European guidelines assign a low class of recommendation to extracorporeal membrane oxygenation (ECMO) for high-risk PE. This systematic review assessed clinical outcomes after ECMO in high-risk PE. We searched electronic databases including PubMed, Embase and Web of Science from January 2000 to April 2020. Efficacy outcomes included in-hospital survival with good neurological outcome and survival at follow-up. Safety outcomes included lower limb ischemia and hemorrhagic and ischemic stroke. Where possible (absence of high heterogeneity), meta-analyses of outcomes were undertaken using a random-effects model. We included 16 uncontrolled case-series (533 participants). In-hospital survival with good neurological outcome ranged between 50% and 95% while overall survival at follow-up ranged from 35% to 95%, both with a major degree of heterogeneity (I2 > 70%). The prevalence of lower limb ischemia was 8% (95% CI 3% to 15%). The prevalence of stroke (either hemorrhagic or ischemic) was 11% (95% CI 3% to 23%), with notable heterogeneity (I² = 63.35%). Based on currently available literature, it is not possible to draw definite conclusions on the usefulness of ECMO for high-risk PE. Prospective, multicenter, large-scale studies or nationwide registries are needed to best define the role of ECMO for high-risk PE. PROSPERO registration ID: CRD42019136282. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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