Venoarterial extracorporeal membrane oxygenation with intra-aortic balloon pump for postcardiotomy cardiogenic shock: A systematic review and meta-analysis,Perfusion

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Venoarterial extracorporeal membrane oxygenation with intra-aortic balloon pump for postcardiotomy cardiogenic shock: A systematic review and meta-analysis
Perfusion ( IF 1.1 ) Pub Date : 2021-09-03 , DOI: 10.1177/02676591211042568
Daochao Huang ₁ , Anyi Xu ₁ , QiongChan Guan ₁ , Jie Qin ₁ , Chuang Zhang ₁

Affiliation

Objective:

Intra-aortic balloon pump (IABP) is currently recommended as a strategy to address the increased afterload in patients who received venoarterial extracorporeal membrane oxygenation (VA-ECMO). The benefit of VA-ECMO with IABP in postcardiotomy cardiogenic shock is inconclusive. A systematic review and meta-analysis was conducted to assess the influence of VA-ECMO with IABP for postcardiotomy cardiogenic shock (PCS).

Methods:

The Cochrane Library, PubMed, and Embase were searched for all articles published from 1 January, 1964 to July 11, 2020. Retrospective cohort studies targeting the comparison of VA-ECMO with IABP and isolated VA-ECMO were included in this study.

Results:

We included 2251 patients in the present study (917 patients in the VA-ECMO with IABP group and 1334 patients in the isolated VA-ECMO group). Deaths occurred in 589 of 917 patients (64.2%) in the VA-ECMO with IABP group and occurred in 885 of 1334 patients (66.3%) in isolated VA-ECMO group. Pooling the results of all studies showed that VA-ECMO with IABP was not related to a reduced in-hospital mortality in patients who received VA-ECMO for PCS (RR, 0.95; 95% CI, 0.86–1.04; p = 0.231). In addition, VA-ECMO with IABP was not related to an increased rate of VA-ECMO weaning in patients who received VA-ECMO for PCS (RR, 1.28; 95% CI, 0.99–1.66; p = 0.058).

Conclusions:

This study indicates that VA-ECMO with IABP did not improve either in-hospital survival or weaning for VA-ECMO in postcardiotomy cardiogenic shock patients.

中文翻译：

主动脉内球囊泵静脉动脉体外膜肺氧合治疗心脏切开术后心源性休克：系统评价和荟萃分析

客观的：

目前推荐使用主动脉内球囊泵 (IABP) 作为解决接受静脉动脉体外膜肺氧合 (VA-ECMO) 患者后负荷增加的策略。VA-ECMO 联合 IABP 在心脏术后心源性休克中的获益尚无定论。进行了一项系统回顾和荟萃分析，以评估 VA-ECMO 联合 IABP 对心脏术后心源性休克 (PCS) 的影响。

方法：

在 Cochrane 图书馆、PubMed 和 Embase 中搜索了从 1964 年 1 月 1 日到 2020 年 7 月 11 日发表的所有文章。本研究包括针对 VA-ECMO 与 IABP 和孤立 VA-ECMO 比较的回顾性队列研究。

结果：

我们在本研究中纳入了 2251 名患者（VA-ECMO 联合 IABP 组 917 名患者和单独 VA-ECMO 组 1334 名患者）。VA-ECMO 联合 IABP 组 917 名患者中有 589 名 (64.2%) 死亡，单独 VA-ECMO 组 1334 名患者中有 885 名 (66.3%) 死亡。汇总所有研究的结果表明，VA-ECMO 联合 IABP 与接受 VA-ECMO 治疗 PCS 的患者院内死亡率降低无关（RR，0.95；95% CI，0.86–1.04；p = 0.231）。此外，VA-ECMO 与 IABP 与接受 VA-ECMO 治疗 PCS 的患者的 VA-ECMO 撤机率增加无关（RR，1.28；95% CI，0.99–1.66；p = 0.058）。