Rachid Eduardo Noleto da Nobrega Oliveira, Felipe S Passos, Bernardo Mulinari Pessoa
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引用次数: 0
Abstract
Aim: This meta-analysis aimed to compare the outcomes of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB) in lung transplantation.
Methods: We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation. Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs). DerSimonian and Laird random-effects model was applied for all endpoints. I2 statistics was used to assess heterogeneity.
Results: Fourteen studies with a total of 1797 patients were included. ECMO was associated with significant reductions in hepatic dysfunction (OR 0.47, 95% CI 0.25-0.90), hemodialysis (OR 0.62, 95% CI 0.43-0.88), severe graft rejection (OR 0.43, 95% CI 0.23-0.78), one-year mortality (OR 0.70; 95% CI 0.51 to 0.98; p = 0.04; I2 = 13%) and tracheostomy rates (OR 0.62, 95% CI 0.46-0.86). Additionally, ECMO reduced the length of hospital stay (MD - 5.69 days, 95% CI - 9.31 to - 2.08) and ICU stay (MD - 6.02 days, 95% CI - 8.32 to - 3.71). However, ECMO was associated with longer total ischemic time (MD 61.07 min, 95% CI 3.51 to 118.62). No significant differences were observed for stroke, thromboembolic events, atrial fibrillation, or 30-day and 3-year mortality.
Conclusions: ECMO offers perioperative advantages in lung transplantation, reducing postoperative complications, one-year mortality, and recovery time compared to CPB. However, the longer total ischemic time with ECMO warrants further investigation into its long-term outcomes.
Trial registry: International Prospective Register of Systematic Reviews; N°: CRD42024604049; URL: https://www.crd.york.ac.uk/prospero/ .
期刊介绍:
The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.