Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis

Low, Christopher Jer Wei; Ling, Ryan Ruiyang; Ramanathan, Kollengode; Chen, Ying; Rochwerg, Bram; Kitamura, Tetsuhisa; Iwami, Taku; Ong, Marcus Eng Hock; Okada, Yohei

doi:10.1186/s13054-024-04830-5

Critical Care

Table 1 General characteristics of all included studies

From: Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis

Study	Study type	Region	Location of arrest	Intervention	Sample size/persons	Age/years	Initial presenting rhythm/persons	In-hospital mortality/ persons	30-day survival/ persons	Short-term favourable neurological outcome /persons
Belohlavek (2022) [6]	RCT	Europe	Out-of-hospital	ECPR	124	59 ± 13.5	72 VF 31 asystole 21 PEA	84	52	38
Belohlavek (2022) [6]	RCT	Europe	Out-of-hospital	CCPR	132	57 ± 13.49	84 VF 24 asystole 24 PEA	101	43	24
Blumenstein (2016)[15]	PSM	Europe	In-hospital	ECPR	52	72 ± 17.46	32 sinus without AV block 15 atrial fibrillation 1 AV block III 1 VT 3 unspecified	38	14	11
Blumenstein (2016)[15]	PSM	Europe	In-hospital	CCPR	52	73 ± 7.62	29 sinus without AV block 13 atrial fibrillation 3 AV block III 3 PEA 2 VT 2 asystole	43	9	7
Chen (2008)[16]	PSM	Asia	In-hospital	ECPR	46	57 ± 14	21 VT/VF 15 PEA 10 asystole	31	16	14
Chen (2008)[16]	PSM	Asia	In-hospital	CCPR	46	55 ± 15	19 VT/VF 18 PEA 9 asystole	38	8	7
Choi (2023) [9]	PSM	Asia	Out-of-hospital	ECPR	458	55.5 ± 14.1	271 VT/VF 96 PEA 91 asystole	391	N/A	47
Choi (2023) [9]	PSM	Asia	Out-of-hospital	CCPR	1832	56.4 ± 16.1	1052 VT/VF 394 PEA 386 asystole	1578	N/A	127
Jeong (2022) [17]	PSM	Asia	Out-of-hospital	ECPR	271	58.0 ± 13.4	N/A	226	45	35
Jeong (2022) [17]	PSM	Asia	Out-of-hospital	CCPR	271	58.3 ± 17.9	N/A	218	53	44
Kim (2020) [14]	PSM	Asia	Out-of-hospital	ECPR	3826	59.8 ± 14.9	N/A	2873	953	N/A
Kim (2020) [14]	PSM	Asia	Out-of-hospital	CCPR	3826	59.7 ± 15.1	N/A	3080	746	N/A
Lin (2010) [18]	PSM	Asia	In-hospital	ECPR	27	59 ± 11	15 VT/VF 7 PEA 5 asystole	19	9	7
Lin (2010) [18]	PSM	Asia	In-hospital	CCPR	27	60 ± 13	18 VT/VF 6 PEA 3 asystole	22	7	5
Maekawa (2013) [19]	PSM	Asia	Out-of-hospital	ECPR	24	57 ± 11.82	13 VT/VF	15	N/A	N/A
Maekawa (2013) [19]	PSM	Asia	Out-of-hospital	CCPR	24	57 ± 14.19	14 VT/VF	21	N/A	N/A
Okada (2023) [8] (shockable rhythm cohort)	PSM	Asia	Out-of-hospital	ECPR	913	58.3 ± 14.9	913 VT/VF	688*	225	109
Okada (2023) [8] (shockable rhythm cohort)	PSM	Asia	Out-of-hospital	CCPR	913	59.0 ± 16.3	913 VT/VF	764*	149	100
Okada (2023) [8] (non-shockable rhythm cohort)	PSM	Asia	Out-of-hospital	ECPR	370	58.7 ± 16.4	237 PEA 133 asystole	326*	44	17
Okada (2023) [8] (non-shockable rhythm cohort)	PSM	Asia	Out-of-hospital	CCPR	370	57.3 ± 17.9	239 PEA 131 asystole	361*	9	4
Patricio (2019) [20]	PSM	Europe	Both in- and out-of-hospital	ECPR	80	57 ± 14	24 VF/VT 35 asystole 21 PEA	62	N/A	N/A
Patricio (2019) [20]	PSM	Europe	Both in- and out-of-hospital	CCPR	80	57 ± 17	23 VT/VF 38 asystole 19 PEA	66	N/A	N/A
Shin (2011/13) [23, 24]	PSM	Asia	Out-of-hospital	ECPR	60	60.8 ± 14.5	13 VT/VF 41 PEA 6 asystole	41	19	14
Shin (2011/13) [23, 24]	PSM	Asia	Out-of-hospital	CCPR	60	60.5 ± 15.5	13 VT/VF 41 PEA 6 asystole	54	6	3
Suverein (2023) [4]	RCT	Europe	Out-of-hospital	ECPR	70	54 ± 12	69 VT/VF/PEA 11 secondary arrhythmia 1 Pulmonary embolism	56	N/A	14
Suverein (2023) [4]	RCT	Europe	Out-of-hospital	CCPR	64	57 ± 10	63 VT/VF/PEA 11 secondary arrhythmia 0 pulmonary embolism	51	N/A	10
Yannopoulos (2020) [5]	RCT	North America	Out-of-hospital	ECPR	15	59 ± 10	15 VF	9	N/A	N/A
Yannopoulos (2020) [5]	RCT	North America	Out-of-hospital	CCPR	15	58 ± 11	15 VF	14	N/A	N/A

AMI acute myocardial infarction, AV atrioventricular, AVR aortic valve replacement, CABG coronary artery bypass graft, CAD coronary artery disease, CCPR conventional cardiopulmonary resuscitation, ECPR extracorporeal cardiopulmonary resuscitation, HF heart failure, ICD implantable cardiac defibrillator, LVEF left ventricular ejection fraction, MVR mitral valve replacement, N/A not available, PCI percutaneous coronary intervention, PEA pulse electrical activity, PSM propensity score matched study, RCT randomised controlled trial, VF ventricular fibrillation, and VT ventricular tachycardia. In-hospital mortality is imputed by 30-day survival

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