Highlights
- •Mortality rate among patients with SAR-COV-2 infection who received ECMO therapy was high in particular in Asia.
- •Complications of ECMO were prevalent including thromboembolic events, circuit thrombosis, and bleeding.
- •A system of care, including patient selection, resource management and referral system, can impact the outcomes of ECMO therapy.
Abstract
Background
Extracorporeal membrane oxygenator (ECMO) is one of the life-saving modalities for
the treatment of multiple organs dysfunction, particularly the heart and the lungs.
Objective
To evaluate the benefit of ECMO for the treatment of SAR-COV-2 infection and its outcomes,
complications, and mortality rate.
Methods
A comprehensive search for articles was performed using MEDLINE and SCOPUS from December
2019 to December 2020. Two independent reviewers selected eligible studies, extracted
the data, assessed the quality of the studies, reviewed the full study protocols,
and reported the findings according to the PRISMA protocol. The meta-analyses were
performed using the Comprehensive Meta-Analysis software version 2.0.
Results
Pooled data from 57 studies was analyzed. There were 7,035 patients with SAR-COV-2
infection with event rate of ECMO treatment was 58.10% (95%CI: 43.70–71.20). The mortality
rate was 16.66% (95%CI: 11.49–23.53). The mean mortality rate of ECMO supported patients
was 35.60% (95%CI: 30.60 to 41.00). Thirty-one percent (95%CI: 24.50–38.40) of the
patients had venous thromboembolic events, 30.90% (95%CI: 17.90–47.80) of the patients
had ECMO circuit thrombosis, and 24.50% (95%CI: 12.50–42.40) of the patients had bleeding.
In the subgroup analysis, the mortality rate was higher among patients who were treated
with ECMO, the pooled odds ratio was 4.47 (95%CI: 2.39–8.35, p < 0.001), and was significantly higher in Asia with an odds ratio of 7.88 (95%CI:
2.40–25.85, p = 0.001).
Conclusion
Mortality rate among patients who received ECMO therapy was high. A system of care,
including patient selection, resource management and referral system, can impact the
outcomes of ECMO therapy.
Keywords
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Article info
Publication history
Published online: January 06, 2023
Accepted:
December 20,
2022
Received in revised form:
December 18,
2022
Received:
September 24,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
