- Author: Hwa Jin Cho, Kollengode Ramanathan,Do Wan Kim, In Seok Jeong
- Date: 2023/09/01
- Journal: ASAIO Journal;69(Suppl 3);24
- PMID:
- PMCID:
- DOI: 10.1097/01.mat.0000990704.36757.fd
Abstract
Objective: Several studies have suggested that extracorporeal membrane oxygenation (ECMO) support may enhance the possibility of survival in adult patients with septic shock. Nonetheless, the clinical results are still inconsistent.
Methods: We systematically searched PubMed, Embase, Scopus, and Cochrane databases up to December 2022, and included all relevant studies reporting on > 10 adult patients requiring ECMO for septic shock. A meta-analysis was performed to accomplish 3 objectives: firstly, to evaluate the overall survival rate in patients with septic shock; secondly, to compare the survival rates between patients receiving ECMO and those not receiving ECMO; and thirdly, to assess the disparities in survival rates between venoarterial (VA)-ECMO and venovenous (VV)-ECMO.
Results: Seventeen observational studies were included in the analysis with a total of 664 ECMO patients. The pooled survival rate in this population was 42.9% (95% Confidence interval (CI): 0.32-0.55%) (Fig. 1) and when analyzing the trend of survival rates based on the years of inclusion studies, the survival rate did not increase (Fig. 2). After including 3 studies (VA-ECMO: 1, VV-ECMO: 2) for adult septic shock, ECMO group demonstrated significant improvement in survival compared to non-ECMO treatment (Fig. 3) (OR = 2.90, 95% CI = 1.14–7.38, P=0.03). VA-ECMO showed no survival enhancement as compared to VV-ECMO (N = 6, OR = 0.61, 95% CI = 0.25-1.47, P=0.27).
Conclusions: More than 40% of septic shock patients treated with ECMO support survive. Use of ECMO may increase survival rates compared to conservative treatment.