The effect of extracorporeal cardiopulmonary resuscitation on prognosis of adult patients with cardiac arrest: meta-analysis

Abstract

Objective To evaluate the effect of extracorporeal cardiopulmonary resuscitation(ECPR)and conventional cardiopulmonary resuscitation (CCPR)on survival and neurological function in adult patients with cardiac arrest. Methods The PubMed and Web of Science were searched to collect relevant literature from Jan 1980 to Nov 2015, and two reviewers strictly distinguished the studies, assessed the quality of studies and picked up the valuable data for statistical analysis by using RevMan 5.0. Results A total of 8 studies involving 27 18 patients were included in our review. Of them, 462 patients were treated with ECPR and 2 256 patients were cared with CCPR. The meta analysis showed that the survival discharge rate (OR=2.92, 95%CI: 2.24-3.81, P<0.01), long-term survival rate (OR=2.97, 95%CI: 2.11-4.19, P<0.01) and neurological function status (OR=3.50, 95%CI: 2.36-5.81, P<0.01) of ECPR (n=182) were better than those of CCPR (n=182). In 4 studies, propensity score matching was used to minimize bias and heterogeneity. The meta analysis also showed that the rate of ROSC, survival discharge rate, long-term survival rate and neurological function status in ECPR were superior over CCPR. Conclusions ECPR would be the excellent measures to improve ROSC rate, survival discharge rate, long-term survival rate and neurological outcome in adult victims with cardiac arrest. Key words: Cardiopulmonary resuscitation; ECPR; CCPR; Survival discharged; Neurological function prognosis; Meta analysis