TY - JOUR
T1 - Systematic review and Meta-analysis comparing low-flow duration of extracorporeal and conventional cardiopulmonary resuscitation
AU - Mandigers, Loes
AU - Boersma, Eric
AU - den Uil, Corstiaan A
AU - Gommers, Diederik
AU - Bělohlávek, Jan
AU - Belliato, Mirko
AU - Lorusso, Roberto
AU - Dos Reis Miranda, Dinis
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
PY - 2022/9/9
Y1 - 2022/9/9
N2 - OBJECTIVES: After cardiac arrest, a key factor determining survival outcomes is low-flow duration. Our aims were to determine the relation of survival and low-flow duration of extracorporeal cardiopulmonary resuscitation and conventional cardiopulmonary resuscitation and if these two therapies have different short term survival curves in relation to low-flow duration.METHODS: We searched Embase, Medline, Web of Science, and Google Scholar from inception up to April 2021. A linear mixed effect model was used to describe the course of survival over time, based on study-specific and time-specific aggregated survival data.RESULTS: We included 42 observational studies reporting on 1,689 extracorporeal cardiopulmonary resuscitation and 375,751 conventional cardiopulmonary resuscitation procedures. Of the included studies, 25 included adults, 13 included children, and four included both. In adults, survival curves decline rapidly over time (extracorporeal cardiopulmonary resuscitation 37.2%-29.8%-23.8%-19.1% versus conventional cardiopulmonary resuscitation-shockable 36.8%-7.2%-1.4%-0.3% for 15-30-45-60 min low-flow, respectively). extracorporeal cardiopulmonary resuscitation was associated with a statistically significant slower decline in survival than conventional cardiopulmonary resuscitation with initial shockable rhythms (conventional cardiopulmonary resuscitation-shockable). In children, survival curves decline rapidly over time (extracorporeal cardiopulmonary resuscitation 43.6%-41.7%-39.8%-38.0% versus CCPR-shockable 48.6%-20.5%-8.6%-3.6% for 15-30-45-60 min low-flow, respectively). extracorporeal cardiopulmonary resuscitation was associated with a statistically significant slower decline in survival than conventional cardiopulmonary resuscitation-shockable.CONCLUSIONS: The short-term survival of extracorporeal cardiopulmonary resuscitation and conventional cardiopulmonary resuscitation-shockable patients both decline rapidly over time, in adults as well as in children. This decline of short-term survival in relation to low-flow duration in extracorporeal cardiopulmonary resuscitation was slower than in conventional cardiopulmonary resuscitation.TRIAL REGISTRATION: Prospero: CRD42020212480, 02-10-2020.
AB - OBJECTIVES: After cardiac arrest, a key factor determining survival outcomes is low-flow duration. Our aims were to determine the relation of survival and low-flow duration of extracorporeal cardiopulmonary resuscitation and conventional cardiopulmonary resuscitation and if these two therapies have different short term survival curves in relation to low-flow duration.METHODS: We searched Embase, Medline, Web of Science, and Google Scholar from inception up to April 2021. A linear mixed effect model was used to describe the course of survival over time, based on study-specific and time-specific aggregated survival data.RESULTS: We included 42 observational studies reporting on 1,689 extracorporeal cardiopulmonary resuscitation and 375,751 conventional cardiopulmonary resuscitation procedures. Of the included studies, 25 included adults, 13 included children, and four included both. In adults, survival curves decline rapidly over time (extracorporeal cardiopulmonary resuscitation 37.2%-29.8%-23.8%-19.1% versus conventional cardiopulmonary resuscitation-shockable 36.8%-7.2%-1.4%-0.3% for 15-30-45-60 min low-flow, respectively). extracorporeal cardiopulmonary resuscitation was associated with a statistically significant slower decline in survival than conventional cardiopulmonary resuscitation with initial shockable rhythms (conventional cardiopulmonary resuscitation-shockable). In children, survival curves decline rapidly over time (extracorporeal cardiopulmonary resuscitation 43.6%-41.7%-39.8%-38.0% versus CCPR-shockable 48.6%-20.5%-8.6%-3.6% for 15-30-45-60 min low-flow, respectively). extracorporeal cardiopulmonary resuscitation was associated with a statistically significant slower decline in survival than conventional cardiopulmonary resuscitation-shockable.CONCLUSIONS: The short-term survival of extracorporeal cardiopulmonary resuscitation and conventional cardiopulmonary resuscitation-shockable patients both decline rapidly over time, in adults as well as in children. This decline of short-term survival in relation to low-flow duration in extracorporeal cardiopulmonary resuscitation was slower than in conventional cardiopulmonary resuscitation.TRIAL REGISTRATION: Prospero: CRD42020212480, 02-10-2020.
U2 - 10.1093/icvts/ivac219
DO - 10.1093/icvts/ivac219
M3 - (Systematic) Review article
C2 - 36000900
SN - 1569-9293
VL - 35
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
IS - 4
M1 - ivac219
ER -