Biancari, Fausto ORCID: 0000-0001-5028-8186, Kaserer, Alexander, Perrotti, Andrea, Ruggieri, Vito G., Cho, Sung-Min ORCID: 0000-0002-5132-0958, Kang, Jin Kook, Dalen, Magnus ORCID: 0000-0001-5352-5132, Welp, Henryk ORCID: 0000-0002-4216-6223, Jonsson, Kristjan, Ragnarsson, Sigurdur, Perez, Francisco J. Hernandez, Gatti, Giuseppe ORCID: 0000-0002-9996-6133, Alkhamees, Khalid, Loforte, Antonio ORCID: 0000-0002-3689-0477, Lechiancole, Andrea, Rosato, Stefano ORCID: 0000-0002-6690-5537, Spadaccio, Cristiano, Pettinari, Matteo, Fiore, Antonio ORCID: 0000-0001-7962-7276, Makikallio, Timo, Sahli, Sebastian D., L'Acqua, Camilla, Arafat, Amr A. ORCID: 0000-0003-0951-7287, Albabtain, Monirah A., AlBarak, Mohammed M., Laimoud, Mohamed, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Krasivskyi, Ihor ORCID: 0000-0003-0573-8218, Samalavicius, Robertas, Puodziukaite, Lina, Alonso-Fernandez-Gatta, Marta ORCID: 0000-0002-4363-8835, Wilhelm, Markus J. and Mariscalco, Giovanni (2022). Central versus Peripheral Postcardiotomy Veno-Arterial Extracorporeal Membrane Oxygenation: Systematic Review and Individual Patient Data Meta-Analysis. J. Clin. Med., 11 (24). BASEL: MDPI. ISSN 2077-0383

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Abstract

Background: It is unclear whether peripheral arterial cannulation is superior to central arterial cannulation for postcardiotomy veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Methods: A systematic review was conducted using PubMed, Scopus, and Google Scholar to identify studies on postcardiotomy VA-ECMO for the present individual patient data (IPD) meta-analysis. Analysis was performed according to the intention-to-treat principle. Results: The investigators of 10 studies agreed to participate in the present IPD meta-analysis. Overall, 1269 patients were included in the analysis. Crude rates of in-hospital mortality after central versus peripheral arterial cannulation for VA-ECMO were 70.7% vs. 63.7%, respectively (adjusted OR 1.38, 95% CI 1.08-1.75). Propensity score matching yielded 538 pairs of patients with balanced baseline characteristics and operative variables. Among these matched cohorts, central arterial cannulation VA-ECMO was associated with significantly higher in-hospital mortality compared to peripheral arterial cannulation VA-ECMO (64.5% vs. 70.8%, p = 0.027). These findings were confirmed by aggregate data meta-analysis, which showed that central arterial cannulation was associated with an increased risk of in-hospital mortality compared to peripheral arterial cannulation (OR 1.35, 95% CI 1.04-1.76, I-2 21%). Conclusions: Among patients requiring postcardiotomy VA-ECMO, central arterial cannulation was associated with an increased risk of in-hospital mortality compared to peripheral arterial cannulation. This increased risk is of limited magnitude, and further studies are needed to confirm the present findings and to identify the mechanisms underlying the potential beneficial effects of peripheral VA-ECMO.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Biancari, FaustoUNSPECIFIEDorcid.org/0000-0001-5028-8186UNSPECIFIED
Kaserer, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perrotti, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruggieri, Vito G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cho, Sung-MinUNSPECIFIEDorcid.org/0000-0002-5132-0958UNSPECIFIED
Kang, Jin KookUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dalen, MagnusUNSPECIFIEDorcid.org/0000-0001-5352-5132UNSPECIFIED
Welp, HenrykUNSPECIFIEDorcid.org/0000-0002-4216-6223UNSPECIFIED
Jonsson, KristjanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ragnarsson, SigurdurUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perez, Francisco J. HernandezUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gatti, GiuseppeUNSPECIFIEDorcid.org/0000-0002-9996-6133UNSPECIFIED
Alkhamees, KhalidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loforte, AntonioUNSPECIFIEDorcid.org/0000-0002-3689-0477UNSPECIFIED
Lechiancole, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosato, StefanoUNSPECIFIEDorcid.org/0000-0002-6690-5537UNSPECIFIED
Spadaccio, CristianoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pettinari, MatteoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fiore, AntonioUNSPECIFIEDorcid.org/0000-0001-7962-7276UNSPECIFIED
Makikallio, TimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sahli, Sebastian D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
L'Acqua, CamillaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arafat, Amr A.UNSPECIFIEDorcid.org/0000-0003-0951-7287UNSPECIFIED
Albabtain, Monirah A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
AlBarak, Mohammed M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laimoud, MohamedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Djordjevic, IlijaUNSPECIFIEDorcid.org/0000-0002-5810-8626UNSPECIFIED
Krasivskyi, IhorUNSPECIFIEDorcid.org/0000-0003-0573-8218UNSPECIFIED
Samalavicius, RobertasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Puodziukaite, LinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alonso-Fernandez-Gatta, MartaUNSPECIFIEDorcid.org/0000-0002-4363-8835UNSPECIFIED
Wilhelm, Markus J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mariscalco, GiovanniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-698589
DOI: 10.3390/jcm11247406
Journal or Publication Title: J. Clin. Med.
Volume: 11
Number: 24
Date: 2022
Publisher: MDPI
Place of Publication: BASEL
ISSN: 2077-0383
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CARDIOGENIC-SHOCK; OUTCOMES; ECMOMultiple languages
Medicine, General & InternalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69858

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