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Chinese Journal of Critical Care Medicine(Electronic Edition) ›› 2024, Vol. 17 ›› Issue (05): 392-398. doi: 10.3877/cma.j.issn.1674-6880.2024.05.006

• Meta-Analysis • Previous Articles    

Risk factors for hemorrhage in adult patients with extracorporeal membrane oxygenation:a meta-analysis

Qiuyang Zhang1, Shaoyun Yu1, Xiangying Pan2, Jiajia Jin2, Hua Xia3, Xuehong Zhao1,()   

  1. 1.Department of Nursing,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China
    2.ICU,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China
    3.Resuscitation Room,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China
  • Received:2024-06-23 Online:2024-10-31 Published:2024-12-13
  • Contact: Xuehong Zhao

Abstract:

Objective

To identify factors associated with hemorrhage in adult patients with extracorporeal membrane oxygenation (ECMO) by a meta-analysis.

Methods

Wanfang, CNKI,China Biomedical Literature Database, VIP, PubMed, Web of Science, Cochrane Library, Embase,CINAHL, and Ovid databases were searched for relative studies on risk factors or predictors of hemorrhage in adult ECMO patients from January 1, 2013 to December 31, 2023.After literature search, screening, and data extraction by two researchers, a meta-analysis was performed using RevMan 5.3.

Results

Twenty-two articles were included, with 13 238 adult ECMO patients.The meta-analysis showed that diabetes, fungal pneumonia, renal failure, rapid decline of arterial partial pressure of carbon dioxide within 2 hours after ECMO initiation, low fibrinogen during support, platelet <100 g / L, ECMO after cardiac surgery, and longer duration of ECMO support were risk factors for hemorrhage in adult ECMO patients (all P <0.05).Arteriovenous ECMO was also a risk factor for hemorrhage after removing heterogeneous sources (P <0.05).

Conclusion

There are many risk factors for bleeding in adult ECMO patients, which can be used as a reference for medical staff to identify high-risk groups and formulate early intervention measures to reduce the occurrence of adverse events.

Key words: Extracorporeal membrane oxygenation, Hemorrhage, Adult, Meta-analysis

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