求助PDF
{"title":"The application of extracorporeal membrane oxygenation in patients with COVID-19: A systematic review and meta-analyses of cohort studies","authors":"S. Yi, M. Mingyuan, G. Qianqian, G. Liheng","doi":"10.7507/1672-2531.202101122","DOIUrl":null,"url":null,"abstract":"Objective To systematically review the application of extracorporeal membrane oxygenation (ECMO) in patients with coronavirus disease 2019 (COVID-19). Methods PubMed, The Cochrane Library, EMbase, CBM, WanFang Data and CNKI databases were searched for studies on ECMO for COVID-19 from December 1st, 2019 to December 31st, 2020. Two researchers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 24 studies were included, involving 1 576 acute respiratory distress syndrome (ARDS) patients with COVID-19. The overall mortality of patients was 27.3% (430/1 576). The rate of ECMO treatment was 4.68% (379/1 576), and the survival rate was 69.4% (263/379). The mean duration of mechanical ventilation prior to ECMO treatment for ARDS patients ranged from 2.07±0.40 to 15.89±13.0 days, compared with 1.64±0.78 days and 29.9±3.60 days for ECMO treatment. Of the 11 studies included in the meta-analysis, 84.0% (405/482) patients with ARDS received conventional treatment with COVID-19, and 16.0% (77/482) received ECMO treatment on the basis of conventional treatment with ARDS. Results of meta-analysis showed that there was statistically significant difference in the survival rate of ARDS patients with COVID-19 treated with conventional therapy combined with ECMO or with conventional therapy alone (RR=1.27, 95%CI 1.00 to 1.62, P=0.05). Conclusions This study suggests that the survival rate of COVID-19 patients after ECMO treatment has a tendency to improve. Due to the limitation of quantity and quality of included studies, the above conclusions are needed to be verified by more high-quality studies. © 2021 West China University of Medical Science. All rights reserved.","PeriodicalId":39892,"journal":{"name":"中国循证医学杂志","volume":"21 1","pages":"803-809"},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国循证医学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7507/1672-2531.202101122","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
引用
批量引用
体外膜氧合在COVID-19患者中的应用:队列研究的系统回顾和荟萃分析
目的系统回顾体外膜氧合(ECMO)在2019冠状病毒病(COVID-19)患者中的应用。方法检索2019年12月1日至2020年12月31日PubMed、Cochrane Library、EMbase、CBM、万方数据和中国知网数据库中关于COVID-19 ECMO的相关研究。两位研究者独立筛选文献,提取数据,并评估纳入研究的偏倚风险。采用RevMan 5.3软件进行meta分析。结果共纳入24项研究,纳入1 576例新冠肺炎急性呼吸窘迫综合征(ARDS)患者。总死亡率为27.3%(430/1 576)。ECMO治愈率为4.68%(379/1 576),生存率为69.4%(263/379)。ECMO治疗前机械通气的平均持续时间为2.07±0.40 ~ 15.89±13.0天,而ECMO治疗前机械通气的平均持续时间为1.64±0.78天和29.9±3.60天。meta分析纳入的11项研究中,84.0%(405/482)的ARDS患者接受了COVID-19的常规治疗,16.0%(77/482)的ARDS患者在常规治疗的基础上接受了ECMO治疗。meta分析结果显示,常规治疗联合ECMO与单独常规治疗合并COVID-19的ARDS患者生存率差异有统计学意义(RR=1.27, 95%CI 1.00 ~ 1.62, P=0.05)。结论新冠肺炎患者经ECMO治疗后生存率有提高的趋势。由于纳入研究数量和质量的限制,上述结论需要更多高质量的研究来验证。©2021华西医科大学。版权所有。
本文章由计算机程序翻译,如有差异,请以英文原文为准。