The Japanese Scientific Research Group of the Ministry of Health, Labour and Welfare for Extracorporeal Cardiopulmonary Resuscitation: Study of Advanced Cardiac Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J), Japan.
Resuscitation. 2011 Jan;82(1):10-4. doi: 10.1016/j.resuscitation.2010.08.032. Epub 2010 Oct 8.
Although favourable outcomes in patients receiving extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest have been frequently reported in Japanese journals since the late 1980s, there has been no meta-analysis of ECPR in Japan. This study reviewed and analysed all previous studies in Japan to clarify the survival rate of patients receiving ECPR.
Case reports, case series and abstracts of scientific meetings of ECPR for out-of-hospital cardiac arrest written in Japanese between 1983 and 2008 were collected. The characteristics and outcomes of patients were investigated, and the influence of publication bias of the case-series studies was examined by the funnel-plot method.
There were 1282 out-of-hospital cardiac arrest patients, who received ECPR in 105 reports during the period. The survival rate at discharge given for 516 cases was 26.7±1.4%. The funnel plot presented the relationship between the number of cases of each report and the survival rate at discharge as the reverse-funnel type that centred on the average survival rate. In-depth review of 139 cases found that the rates of good recovery, mild disability, severe disability, vegetative state, death at hospital discharge and non-recorded in all cases were 48.2%, 2.9%, 2.2%, 2.9%, 37.4% and 6.4%, respectively.
Based on the results of previous reports with low publication bias in Japan, ECPR appears to provide a higher survival rate with excellent neurological outcome in patients with out-of-hospital cardiac arrest.
尽管自 20 世纪 80 年代末以来，日本期刊频繁报道了接受体外心肺复苏术（ECPR）治疗的院外心脏骤停患者的良好结局，但日本尚未对 ECPR 进行荟萃分析。本研究回顾和分析了日本所有以前的研究，以阐明接受 ECPR 的患者的生存率。
收集了 1983 年至 2008 年间用日语发表的关于院外心脏骤停的 ECPR 的病例报告、病例系列和科学会议摘要。调查了患者的特征和结局，并通过漏斗图法检查了病例系列研究的发表偏倚的影响。
共有 1282 例院外心脏骤停患者，在 105 份报告中接受了 ECPR。516 例出院时的存活率为 26.7±1.4%。漏斗图呈现了每个报告的病例数与出院时的存活率之间的关系，呈漏斗形，以平均存活率为中心。对 139 例病例的深入审查发现，良好恢复、轻度残疾、重度残疾、植物状态、出院时死亡和未记录在案的比例分别为 48.2%、2.9%、2.2%、2.9%、37.4%和 6.4%。
根据日本以前报告的结果，这些报告的发表偏倚较低，ECPR 似乎为院外心脏骤停患者提供了更高的生存率和良好的神经结局。
