Venoarterial extracorporeal membrane oxygenation

A systematic review of selection criteria, outcome measures and definitions of complications

Aidan J.C. Burrell, Victoria Bennett, Alexis L. Serra, Vincent A. Pellegrino, Lorena Romero, Eddy Fan, Daniel Brodie, D. James Cooper, David M. Kaye, John F. Fraser, Carol L. Hodgson, for the International ECMO Network (ECMONet)

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Purpose: The purpose of this study was to systematically investigate the reporting of selection criteria and outcome measures, and to examine definitions of complications used in venoarterial extracorporeal membrane oxygenation studies (V-A ECMO). Materials and methods: Medline, EMBASE and the Cochrane central register were searched for V-A ECMO studies from January 2005 to July 2017. Studies with ≤99 patients or without patient centered outcomes were excluded. Two reviewers independently assessed search results and undertook data extraction. Results: Forty-six studies met the inclusion criteria, and all were retrospective, observational studies. Inconsistent reporting of selection criteria, ECMO management and outcome measures was common. In-hospital mortality was the most common primary outcome (41% of studies), followed by 30-day mortality (11%). Bleeding was the most frequent complication reported, most commonly defined as “bleeding requiring transfusion” (median ≥ 2 Units/day). Significant variation in reporting and definitions was also evident for vascular, neurological renal and infectious complications. Conclusion: This systematic review provides clinicians with the most commonly reported selection criteria, outcome measures and complications used in ECMO practice. However non-standardized definitions and inconsistent reporting limits their ability to inform practice. New consensus driven definitions of complications and patient centred outcomes are urgently needed.

Original languageEnglish
Pages (from-to)32-37
Number of pages6
JournalJournal of Critical Care
Volume53
DOIs
Publication statusPublished - 24 May 2019

Keywords

  • Definitions
  • Extracorporeal membrane oxygenation
  • Heart failure
  • Outcomes
  • Venoarterial

Cite this

Burrell, Aidan J.C. ; Bennett, Victoria ; Serra, Alexis L. ; Pellegrino, Vincent A. ; Romero, Lorena ; Fan, Eddy ; Brodie, Daniel ; Cooper, D. James ; Kaye, David M. ; Fraser, John F. ; Hodgson, Carol L. ; for the International ECMO Network (ECMONet). / Venoarterial extracorporeal membrane oxygenation : A systematic review of selection criteria, outcome measures and definitions of complications. In: Journal of Critical Care. 2019 ; Vol. 53. pp. 32-37.
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Venoarterial extracorporeal membrane oxygenation : A systematic review of selection criteria, outcome measures and definitions of complications. / Burrell, Aidan J.C.; Bennett, Victoria; Serra, Alexis L.; Pellegrino, Vincent A.; Romero, Lorena; Fan, Eddy; Brodie, Daniel; Cooper, D. James; Kaye, David M.; Fraser, John F.; Hodgson, Carol L.; for the International ECMO Network (ECMONet).

In: Journal of Critical Care, Vol. 53, 24.05.2019, p. 32-37.

Research output: Contribution to journalReview ArticleResearchpeer-review

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T1 - Venoarterial extracorporeal membrane oxygenation

T2 - A systematic review of selection criteria, outcome measures and definitions of complications

AU - Burrell, Aidan J.C.

AU - Bennett, Victoria

AU - Serra, Alexis L.

AU - Pellegrino, Vincent A.

AU - Romero, Lorena

AU - Fan, Eddy

AU - Brodie, Daniel

AU - Cooper, D. James

AU - Kaye, David M.

AU - Fraser, John F.

AU - Hodgson, Carol L.

AU - for the International ECMO Network (ECMONet)

PY - 2019/5/24

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N2 - Purpose: The purpose of this study was to systematically investigate the reporting of selection criteria and outcome measures, and to examine definitions of complications used in venoarterial extracorporeal membrane oxygenation studies (V-A ECMO). Materials and methods: Medline, EMBASE and the Cochrane central register were searched for V-A ECMO studies from January 2005 to July 2017. Studies with ≤99 patients or without patient centered outcomes were excluded. Two reviewers independently assessed search results and undertook data extraction. Results: Forty-six studies met the inclusion criteria, and all were retrospective, observational studies. Inconsistent reporting of selection criteria, ECMO management and outcome measures was common. In-hospital mortality was the most common primary outcome (41% of studies), followed by 30-day mortality (11%). Bleeding was the most frequent complication reported, most commonly defined as “bleeding requiring transfusion” (median ≥ 2 Units/day). Significant variation in reporting and definitions was also evident for vascular, neurological renal and infectious complications. Conclusion: This systematic review provides clinicians with the most commonly reported selection criteria, outcome measures and complications used in ECMO practice. However non-standardized definitions and inconsistent reporting limits their ability to inform practice. New consensus driven definitions of complications and patient centred outcomes are urgently needed.

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