Comparison of ECMO vs ECpella in Patients With Non-Post-Pericardiotomy Cardiogenic Shock: An Updated Meta-Analysis.

Autor: Iannaccone M; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy. Electronic address: mario.iannaccone@hotmail.it., Venuti G; Division of Cardiology, A.O. Papardo, Messina, Italy., di Simone E; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., De Filippo O; Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy., Bertaina M; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., Colangelo S; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., Boccuzzi G; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., de Piero ME; Department of Anesthesiology and Intensive Care, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., Attisani M; Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy., Barbero U; Division of Cardiology, Sevigliano, ASL CN1, Italy., Zanini P; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., Livigni S; Department of Anesthesiology and Intensive Care, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., Noussan P; Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy., D'Ascenzo F; Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy., de Ferrari GM; Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy., Porto I; Cardiovascular Disease Unit, IRCCS Policlinic Hospital San Martino, Genova, Italy., Truesdell AG; Virginia Heart/Inova Heart and Vascular Institute, Falls Church, VA, USA.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2022 Jul; Vol. 40, pp. 134-141. Date of Electronic Publication: 2021 Oct 05.
DOI: 10.1016/j.carrev.2021.10.001
Abstrakt: Introduction: The impact of Impella and ECMO (ECPELLA) in cardiogenic shock (CS) remains to be defined. The aim of this meta-analysis is to evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non post-pericardiotomy CS.
Methods: All studies reporting short term outcomes of ECpella or VA ECMO in non post-pericardiotomy CS were included. The primary endpoint was 30-day mortality. Vascular and bleeding complications and LVAD implantation/heart transplant within 30-days were assessed as secondary outcomes.
Results: Of 407 studies identified, 13 observational studies (13,682 patients, 13,270 with ECMO and 412 with ECpella) were included in this analysis. 30-day mortality was 55.8% (51.6-59.9) in the VA-ECMO group and 58.3% (53.5-63.0) in the ECpella group. At meta-regression analysis the implantation of IABP did not affect mortality in the ECMO group. The rate of major bleeding in patients on VA-ECMO and ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2) respectively, while the rates of the composite outcome of LVAD implantation and heart transplantation within 30-days in patients on VA-ECMO and ECpella support were 14.4% (9.0-22.2) and 10.8%. When directly compared in 3 studies, ECpella showed a positive effect on 30-day mortality compared to ECMO (OR: 1.81: 1.039-3.159).
Conclusion: Our data suggest that ECpella may reduce 30-day mortality and increase left ventricle recovery, despite increased of bleeding rates.
Competing Interests: Declaration of competing interest The authors report no relationships that could be construed as a conflict of interest.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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