Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea.
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Int J Artif Organs. 2021 Jul;44(7):481-488. doi: 10.1177/0391398820975408. Epub 2020 Dec 1.
Venovenous extracorporeal membrane oxygenation (VV ECMO) has gained popularity for the treatment of refractory respiratory failure during and after the 2009 influenza pandemic, and still represents a precious therapeutic resource for severe novel coronavirus 2019 infection. However, most of the published studies are small case series, and only two randomized trials exist in literature.
Aim of this systematic review is to describe trends in VV ECMO treatment outcomes according to large studies only.
We searched and included studies with more than 100 VV ECMO cases dated up to August 1st, 2019.
Thirty-three studies published in the period 2011-2019 met inclusion criteria, for a total of 12,860 patients (age 46.3 ± 17.4 years). ARDS was mainly by pneumonia, in 3126 (37%) cases; further 401(7%) patients had H1N1 Influenza A infection. Cannulation-related complications occurred in 502 (7%) cases. Weighted mean (95% confidence interval) of VV ECMO duration was 8.9 (8.7-9.1) days, and ICU stay was 23.6 (22.4-24.8) days. Mortality at the longest follow up available was 40%. Data collection in 70% of the studies had a duration of >5 years.
This study reveals the characteristics of large case VV ECMO studies.
静脉-静脉体外膜肺氧合（VV ECMO）在 2009 年流感大流行期间和之后用于治疗难治性呼吸衰竭，已广受欢迎，并且仍然是严重新型冠状病毒 2019 感染的宝贵治疗资源。但是，大多数已发表的研究都是小病例系列，文献中仅存在两项随机试验。
本系统评价的目的是仅根据大型研究描述 VV ECMO 治疗结果的趋势。
我们搜索并纳入了截至 2019 年 8 月 1 日，VV ECMO 病例超过 100 例的研究。
2011 年至 2019 年期间发表的 33 项研究符合纳入标准，共 12860 例患者（年龄 46.3±17.4 岁）。ARDS 主要由肺炎引起，占 3126 例（37%）；另有 401 例（7%）患者感染 H1N1 甲型流感。发生 502 例（7%）与置管相关的并发症。VV ECMO 持续时间的加权平均值（95%置信区间）为 8.9（8.7-9.1）天，ICU 住院时间为 23.6（22.4-24.8）天。在最长随访期可获得的死亡率为 40%。70%的研究的数据收集时间超过 5 年。
本研究揭示了大型 VV ECMO 研究的特点。
