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SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 11 - 2024 |
doi: 10.3389/fcvm.2024.1431875
This article is part of the Research Topic Organ Support in Cardiac Intensive Care View all 7 articles
Efficacy of Venoarterial Extracorporeal Membrane Oxygenation with and without Intra-Aortic Balloon Pump in adult cardiogenic shock
Provisionally accepted- 1 Tianjin University, Tianjin, China
- 2 Wenzhou Safety (Emergency) Institute, Wenzhou, China
- 3 Laboratory of Extracorporeal Life Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
Intra-aortic balloon pump (IABP) is sometimes coupled with Venoarterial extracorporeal membrane oxygenation (VA-ECMO) to treat patients with cardiogenic shock. In this study, we attempted to evaluate the association of the IABP approach on survival and vascular complication rates in adults with cardiogenic shock undergoing VA-ECMO. We performed a systematic search of original studies on VA-ECMO with and without IABP in PubMed, EMBASE, and the Cochrane Library. A total of 42 studies with 8,759 patients were included. The pooled in-hospital deaths of patients on VA-ECMO with and without IABP were 2,962/4,807 (61.61%) versus 2,666/3,952 (67.45%). VA-ECMO with IABP presents lower in-hospital mortality [risk ratio, 0.88; 95% CI, 0.86-0.91; P<0.00001]. In addition, IABP was associated with lower in-hospital mortality of patients with postcardiotomy cardiogenic shock and ischaemic heart disease. (risk ratio, 0.93; 95% CI, 0.87-0.98; P=0.01; risk ratio, 0.85; 95% CI, 0.82-0.89; P<0.00001). There was no significant difference in in-hospital morbidity in neurological, gastrointestinal, limb-related, bleeding, and infection complications between patients on VA-ECMO with and without IABP. In these observational studies, concomitant use of IABP and VA-ECMO in adult patients with cardiogenic shock was associated with reduced in-hospital mortality.
Keywords: Cardiogenic shock, Venoarterial extracorporeal membrane oxygenation, Intraaortic balloon pump, Survival, complications, Meta-analysis
Received: 13 May 2024; Accepted: 23 Aug 2024.
Copyright: © 2024 Wang, Li, Li, Chen, Li, Liu, Li, Fan and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yanqing Liu, Tianjin University, Tianjin, China
Yongnan Li, Laboratory of Extracorporeal Life Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
Haojun Fan, Tianjin University, Tianjin, China
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