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Extracorporeal Life Support: The Next Step in Moderate to Severe ARDS—A Review and Meta-Analysis of the Literature
Joint Authors
Aretha, Diamanto
Fligou, Fotini
Kiekkas, Panagiotis
Karamouzos, Vasilis
Voyagis, Gregorios
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-11, 11 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-09-29
Country of Publication
Egypt
No. of Pages
11
Main Subjects
Abstract EN
Despite the use of lung protective ventilation (LPV) strategies, a severe form of acute respiratory distress syndrome (ARDS) is unfortunately associated with high mortality rates, which sometimes exceed 60%.
Recently, major technical improvements have been applied in extracorporeal life support (ECLS) systems, but as these techniques are costly and associated with very serious adverse events, high-quality evidence is needed before these techniques can become the “cornerstone” in the management of moderate to severe ARDS.
Unfortunately, evaluation of previous randomized controlled and observational trials revealed major methodological issues.
In this review, we focused on the most important clinical trials aiming at a final conclusion about the effectiveness of ECLS in moderate to severe ARDS patients.
Totally, 20 published clinical studies were included in this review.
Most studies have important limitations with regard to quality and design.
In the 20 included studies (2,956 patients), 1,185 patients received ECLS.
Of them, 976 patients received extracorporeal membrane oxygenation (ECMO) and 209 patients received extracorporeal carbon dioxide removal (ECCO2R).
According to our results, ECLS use was not associated with a benefit in mortality rate in patients with ARDS.
However, when restricted to higher quality studies, ECMO was associated with a significant benefit in mortality rate.
Furthermore, in patients with H1N1, a potential benefit of ECLS in mortality rate was apparent.
Until more high-quality data are derived, ECLS should be an option as a salvage therapy in severe hypoxemic ARDS patients.
American Psychological Association (APA)
Aretha, Diamanto& Fligou, Fotini& Kiekkas, Panagiotis& Karamouzos, Vasilis& Voyagis, Gregorios. 2019. Extracorporeal Life Support: The Next Step in Moderate to Severe ARDS—A Review and Meta-Analysis of the Literature. BioMed Research International،Vol. 2019, no. 2019, pp.1-11.
https://search.emarefa.net/detail/BIM-1123123
Modern Language Association (MLA)
Aretha, Diamanto…[et al.]. Extracorporeal Life Support: The Next Step in Moderate to Severe ARDS—A Review and Meta-Analysis of the Literature. BioMed Research International No. 2019 (2019), pp.1-11.
https://search.emarefa.net/detail/BIM-1123123
American Medical Association (AMA)
Aretha, Diamanto& Fligou, Fotini& Kiekkas, Panagiotis& Karamouzos, Vasilis& Voyagis, Gregorios. Extracorporeal Life Support: The Next Step in Moderate to Severe ARDS—A Review and Meta-Analysis of the Literature. BioMed Research International. 2019. Vol. 2019, no. 2019, pp.1-11.
https://search.emarefa.net/detail/BIM-1123123
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1123123