Loes Mandigers, Eric Boersma, Corstiaan A den Uil, Diederik Gommers, Jan Bělohlávek, Mirko Belliato, Roberto Lorusso, Dinis Dos Reis Miranda
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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.</p><p><strong>Results: </strong>We included 42 observational studies reporting on 1689 ECPR and 375 751 CCPR procedures. Of the included studies, 25 included adults, 13 included children and 4 included both. In adults, survival curves decline rapidly over time (ECPR 37.2%, 29.8%, 23.8% and 19.1% versus CCPR-shockable 36.8%, 7.2%, 1.4% and 0.3% for 15, 30, 45 and 60 min low-flow, respectively). ECPR was associated with a statistically significant slower decline in survival than CCPR with initial shockable rhythms (CCPR-shockable). In children, survival curves decline rapidly over time (ECPR 43.6%, 41.7%, 39.8% and 38.0% versus CCPR-shockable 48.6%, 20.5%, 8.6% and 3.6% for 15, 30, 45 and 60 min low-flow, respectively). ECPR was associated with a statistically significant slower decline in survival than CCPR-shockable.</p><p><strong>Conclusions: </strong>The short-term survival of ECPR and CCPR-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 ECPR was slower than in conventional cardiopulmonary resuscitation.</p><p><strong>Trial registration: </strong>Prospero: CRD42020212480, 2 October 2020.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/5f/ivac219.PMC9491846.pdf","citationCount":"8","resultStr":"{\"title\":\"Systematic review and meta-analysis comparing low-flow duration of extracorporeal and conventional cardiopulmonary resuscitation.\",\"authors\":\"Loes Mandigers, Eric Boersma, Corstiaan A den Uil, Diederik Gommers, Jan Bělohlávek, Mirko Belliato, Roberto Lorusso, Dinis Dos Reis Miranda\",\"doi\":\"10.1093/icvts/ivac219\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>After cardiac arrest, a key factor determining survival outcomes is low-flow duration. 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ECPR was associated with a statistically significant slower decline in survival than CCPR with initial shockable rhythms (CCPR-shockable). In children, survival curves decline rapidly over time (ECPR 43.6%, 41.7%, 39.8% and 38.0% versus CCPR-shockable 48.6%, 20.5%, 8.6% and 3.6% for 15, 30, 45 and 60 min low-flow, respectively). ECPR was associated with a statistically significant slower decline in survival than CCPR-shockable.</p><p><strong>Conclusions: </strong>The short-term survival of ECPR and CCPR-shockable patients both decline rapidly over time, in adults as well as in children. 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引用次数: 8
摘要
目的:心脏骤停后,决定生存结果的关键因素是低流量持续时间。我们的目的是确定体外心肺复苏(ECPR)和常规心肺复苏(CCPR)的生存与低流量持续时间的关系,以及这两种治疗方法是否具有不同的与低流量持续时间相关的短期生存曲线。方法:检索Embase、Medline、Web of Science和Google Scholar数据库,检索时间从成立之初至2021年4月。基于特定研究和特定时间的总体生存数据,使用线性混合效应模型来描述随时间的生存过程。结果:我们纳入了42项观察性研究,报告了1689例ECPR和375 751例CCPR手术。在纳入的研究中,25项包括成人,13项包括儿童,4项包括两者。在成人中,生存曲线随着时间的推移迅速下降(低流量15、30、45和60分钟时,ECPR为37.2%、29.8%、23.8%和19.1%,ccpr为36.8%、7.2%、1.4%和0.3%)。与具有初始休克节律(CCPR-shockable)的CCPR相比,ECPR与生存率下降的统计学意义显著相关。在儿童中,生存曲线随着时间的推移迅速下降(低流量15、30、45和60分钟时,ECPR为43.6%、41.7%、39.8%和38.0%,ccpr为48.6%、20.5%、8.6%和3.6%)。与ccpr -休克相比,ECPR与生存率下降有统计学意义。结论:无论是成人还是儿童,ECPR和ccpr -休克患者的短期生存率都随着时间的推移而迅速下降。与低流量持续时间相比,ECPR短期生存期的下降速度要慢于常规心肺复苏。试验注册:Prospero: CRD42020212480, 2020年10月2日。
Systematic review and meta-analysis comparing low-flow duration of extracorporeal and conventional cardiopulmonary resuscitation.
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 (ECPR) and conventional cardiopulmonary resuscitation (CCPR) and if these 2 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 1689 ECPR and 375 751 CCPR procedures. Of the included studies, 25 included adults, 13 included children and 4 included both. In adults, survival curves decline rapidly over time (ECPR 37.2%, 29.8%, 23.8% and 19.1% versus CCPR-shockable 36.8%, 7.2%, 1.4% and 0.3% for 15, 30, 45 and 60 min low-flow, respectively). ECPR was associated with a statistically significant slower decline in survival than CCPR with initial shockable rhythms (CCPR-shockable). In children, survival curves decline rapidly over time (ECPR 43.6%, 41.7%, 39.8% and 38.0% versus CCPR-shockable 48.6%, 20.5%, 8.6% and 3.6% for 15, 30, 45 and 60 min low-flow, respectively). ECPR was associated with a statistically significant slower decline in survival than CCPR-shockable.
Conclusions: The short-term survival of ECPR and CCPR-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 ECPR was slower than in conventional cardiopulmonary resuscitation.
Trial registration: Prospero: CRD42020212480, 2 October 2020.
期刊介绍:
Interactive CardioVascular and Thoracic Surgery (ICVTS) publishes scientific contributions in the field of cardiovascular and thoracic surgery, covering all aspects of surgery of the heart, vessels and the chest. The journal publishes a range of article types including: Best Evidence Topics; Brief Communications; Case Reports; Original Articles; State-of-the-Art; Work in Progress Report.