[Use of extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome: a meta-analysis].

OBJECTIVE

To evaluate the effects of extracorporeal membrane oxygenation (ECMO) on mortality in adult patients with acute respiratory distress syndrome (ARDS).

METHODS

Literature concerning randomized controlled trials (RCTs), case-control studies and prospective cohort studies from January 1966 to July 2011 on ECMO for the treatment of ARDS patients was retrieved by electronic and manual search. Meta-analysis of the use of ECMO in the treatment of ARDS patients was conducted using the methods recommended by the Cochrane Collaboration's software RevMan 5.0.

RESULTS

Three papers reporting RCTs and 6 papers concerning observational cohort studies of using ECMO in patients with severe ARDS were enrolled for analysis. Meta-analysis of the 3 RCTs (310 patients, 159 of them treated with ECMO) revealed ECMO did not decrease the mortality of ARDS patients [odds ratio (OR)=0.75, 95% confidence interval (95%CI) 0.45-1.24, P = 0.27]. Meta-analysis of the all 9 studies (1058 patients, 386 of them treated with ECMO) revealed ECMO increased the mortality of ARDS patients (OR=1.58, 95%CI 0.94-2.67, P = 0.08).

CONCLUSION

There is no evidence to prove that ECMO is beneficial in adult patients with ARDS, therefore further investigation with a large sample of high quality RCT is warranted.