Survival prognosis of extracorporeal membrane oxygenation on patients with sepsis: a meta-analysis

doi:10.3877/cma.j.issn.1674-6880.2022.01.010

Abstract

Abstract:

Objective

To systematically evaluate the effect of extracorporeal membrane oxygenation (ECMO) on the survival rate of patients with sepsis.

Methods

The articles about ECMO for sepsis patients published from January 2011 to July 2020 were searched in CNKI, Wanfang, VIP, China Biomedical Literature Service System, PubMed, Web of Science, Cochrane Library, and Embase databases. Two researchers independently screened articles, extracted data, and evaluated the quality of articles. Then the meta-analysis was performed using the Stata 15.0 software.

Results

A total of 660 patients from 13 articles were included in this study. Meta-analysis showed that the discharge survival rates of sepsis patients treated by ECMO [risk ratio (RR) = 0.32, 95% confidence interval (CI) (0.22, 0.42), Z = 9.841, P < 0.001], veno-arterial ECMO (VA-ECMO) [RR = 0.29, 95%CI (0.17, 0.42), Z = 7.100, P < 0.001], and veno-venous ECMO (VV-ECMO) [RR = 0.53, 95%CI (0.40, 0.66), Z = 14.950, P < 0.001] all improved obviously. The discharge survival rates in patients with septic shock [RR = 0.33, 95%CI (0.19, 0.46), Z = 4.686, P < 0.001], patients with sepsis caused by pulmonary infection [RR = 0.22, 95%CI (0.13, 0.32), Z = 7.140, P < 0.001], and patients with sepsis > 60 years of age [RR = 0.06, 95%CI (0.00, 0.15), Z = 2.108, P = 0.011], as well as the long-term survival rate of patients with sepsis [RR = 0.82, 95%CI (0.70, 0.94), Z = 13.410, P < 0.001] all increased remarkably after ECMO treatment.

Conclusion

ECMO treatment can improve the prognosis of patients with sepsis.

Key words: Extracorporeal membrane oxygenation, Sepsis, Shock, septic, Survival rate, Meta-analysis

Shaotao Kang, Abuduaini Buzukela·, Yingjie Li, Tuerdi Baihetinisha·. Survival prognosis of extracorporeal membrane oxygenation on patients with sepsis: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2022, 15(01): 51-59.

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References 47

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纳入研究	例数（休克例数）	疾病类型	出院生存例数（休克生存例数）	年龄（岁，中位数）		生存比例（生存人数/总人数）				长期生存例数（随访月数）	质量评价（分）
纳入研究	例数（休克例数）	疾病类型	出院生存例数（休克生存例数）	存活组	死亡组	VA-ECMO	VV-ECMO	肺源性	年龄>60岁	长期生存例数（随访月数）	质量评价（分）
Huang等^[9]	52	脓毒性休克	8	43.8	59.3	-	-	6/25	0/20	-	14
Cheng等^[10]	108	脓毒症	31	52.0		21/86	10/22	-	-	-	14
Park等^[11]	32	脓毒性休克	7	53	56	7/32	-	3/11	-	-	14
Choi等^[12]	28	脓毒性休克	10	39	51.5	6/21	3/4	3/13	-	9（13.9）	14
Cheng等^[13]	151（91）	脓毒症及脓毒性休克	45（25）	43	55	25/101	20/50	18/76	4/30	-	14
Ro等^[14]	71	脓毒性休克	5	58.0	57.5	5/71	-	3/49	-	-	14
Takauji等^[15]	40	脓毒症	19	66		-	19/40		-	-	14
Takauji等^[16]	30	脓毒症	6	55	55	6/30	-	1/8	-	-	14
Kim等^[17]	37	脓毒性休克	15	44.0	52.5	7/26	7/8	6/17	-	-	14
Banjas等^[18]	19	脓毒性休克	8	62		-	-	-	-	-	14
Han等^[19]	23	脓毒性休克	5	45	54	5/23	-	-	-	-	14
Myers等^[20]	32	脓毒性休克	13	34	46	5/11	8/21	9/23	-	-	14
Falk等^[21]	37	脓毒性休克	29	54.7		23/27	6/10	-	-	22（46.1）	14

纳入研究	例数（休克例数）	疾病类型	出院生存例数（休克生存例数）	年龄（岁，中位数）		生存比例（生存人数/总人数）				长期生存例数（随访月数）	质量评价（分）
纳入研究	例数（休克例数）	疾病类型	出院生存例数（休克生存例数）	存活组	死亡组	VA-ECMO	VV-ECMO	肺源性	年龄>60岁	长期生存例数（随访月数）	质量评价（分）
Huang等^[9]	52	脓毒性休克	8	43.8	59.3	-	-	6/25	0/20	-	14
Cheng等^[10]	108	脓毒症	31	52.0		21/86	10/22	-	-	-	14
Park等^[11]	32	脓毒性休克	7	53	56	7/32	-	3/11	-	-	14
Choi等^[12]	28	脓毒性休克	10	39	51.5	6/21	3/4	3/13	-	9（13.9）	14
Cheng等^[13]	151（91）	脓毒症及脓毒性休克	45（25）	43	55	25/101	20/50	18/76	4/30	-	14
Ro等^[14]	71	脓毒性休克	5	58.0	57.5	5/71	-	3/49	-	-	14
Takauji等^[15]	40	脓毒症	19	66		-	19/40		-	-	14
Takauji等^[16]	30	脓毒症	6	55	55	6/30	-	1/8	-	-	14
Kim等^[17]	37	脓毒性休克	15	44.0	52.5	7/26	7/8	6/17	-	-	14
Banjas等^[18]	19	脓毒性休克	8	62		-	-	-	-	-	14
Han等^[19]	23	脓毒性休克	5	45	54	5/23	-	-	-	-	14
Myers等^[20]	32	脓毒性休克	13	34	46	5/11	8/21	9/23	-	-	14
Falk等^[21]	37	脓毒性休克	29	54.7		23/27	6/10	-	-	22（46.1）	14

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