OBJECTIVE: To evaluate the effect of extracorporeal membrane oxygenation (ECMO) on survival and complication rates in adults with refractory @entity1455 or @entity1167 . DESIGN: Meta-analysis. SETTING: University hospitals. @entity1 : One thousand one hundred ninety-nine @entity1 from 22 observational studies. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Observational studies published from the year 2000 onwards, examining at least 10 adult @entity1 who received ECMO for refractory @entity1455 or @entity1167 were included. Pooled estimates with 95% confidence intervals were calculated based on the Freeman-Tukey double-arcsine transformation and DerSimonian-Laird random-effect model. Survival to discharge was 40.2% (95% confidence intervals [CI], 33.9-46.7), while survival at 3, 6, and 12 months was 55.9% (95% CI, 41.5-69.8), 47.6% (95% CI, 25.4-70.2), and 54.4% (95% CI, 36.6-71.7), respectively. Survival up to 30 days was higher in @entity1455 @entity1 (52.5%, 95% CI, 43.7%-61.2%) compared to @entity1167 (36.2%, 95% CI, 23.1%-50.4%). Concurrently, complication rates were particularly substantial for @entity51 (13.3%, 95% CI, 8.3-19.3), @entity281 (25.1%, 95%CI, 15.9-35.5), and @entity8 (47.4%, 95% CI, 30.2-64.9). Significant heterogeneity was detected, although its levels were similar to previous meta-analyses that only examined short-term survival to discharge. CONCLUSIONS: Venoarterial ECMO can improve short-term survival in adults with refractory @entity1455 or @entity1167 . It also may provide favorable long-term survival at up to 3 years postdischarge. However, ECMO also is associated with significant complication rates, which must be incorporated into the risk-benefit analysis when considering treatment. These findings require confirmation by large, adequately controlled and standardized trials with long-term follow-up.

Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and XXXX : A Meta-Analysis.

@entity1 :: ('9606', 'Species') :: ['patients', 'PARTICIPANTS'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal impairment'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurologic deficits'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest'] @entity1455 :: ('MESH:D012770', 'Disease') :: ['cardiogenic shock']
@entity1167 :: (MESH:D006323,Disease) :: ['Cardiac Arrest']
