Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241279293. doi: 10.1177/10760296241279293.
This study investigates the prevalence and risk factors associated with venous thrombotic events in patients receiving (ECMO) support. Systematic review and meta-analysis of case-control and cohort studies. PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, and ProQuest databases from inception through November 25, 2023.Case-control and cohort studies focusing on the prevalence and risk factors for venous thrombotic events in patients supported by ECMO. Identification of risk factors and calculation of incidence rates. Nineteen studies encompassing 10,767 participants were identified and included in the analysis. The pooled prevalence of venous thrombotic events among patients receiving ECMO support was 48% [95% confidence interval (CI) 0.37-0.60, I= 97.18%]. Factors associated with increased incidence rates included longer duration of ECMO support (odds ratio [OR] 1.08, 95% CI 1.07-1.09, I= 49%), abnormal anti-coagulation monitoring indicators (OR 1.02, 95% CI 1.00-1.04, I84%), and type of ECMO cannulation (OR 1.77, 95% CI 1.14-3.34, I= 64%). The pooled prevalence of venous thrombotic events in patients with ECMO support is high. Increased risk is associated with extended duration of ECMO support, abnormal anti-coagulation monitoring, and specific types of ECMO cannulation.
本研究调查了接受(ECMO)支持的患者中静脉血栓栓塞事件的患病率和相关风险因素。对病例对照和队列研究进行系统评价和荟萃分析。从开始到 2023 年 11 月 25 日,检索 PubMed、Cochrane 图书馆、Embase、CINAHL、Web of Science、Scopus 和 ProQuest 数据库。病例对照和队列研究重点关注接受 ECMO 支持的患者中静脉血栓栓塞事件的患病率和风险因素。确定风险因素并计算发病率。确定了 19 项研究,共纳入 10767 名参与者进行分析。接受 ECMO 支持的患者中静脉血栓栓塞事件的总患病率为 48%[95%置信区间 (CI) 0.37-0.60,I=97.18%]。与发病率增加相关的因素包括 ECMO 支持时间延长(比值比 [OR] 1.08,95%CI 1.07-1.09,I=49%)、抗凝监测指标异常(OR 1.02,95%CI 1.00-1.04,I84%)和 ECMO 插管类型(OR 1.77,95%CI 1.14-3.34,I=64%)。接受 ECMO 支持的患者中静脉血栓栓塞事件的总患病率较高。风险增加与 ECMO 支持时间延长、抗凝监测异常和特定类型的 ECMO 插管有关。