Prognostic factors associated with mortality among patients receiving venovenous extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis
Authors' conclusion
The prognostic factors identified highlight the importance of patient selection, the effect of injurious lung ventilation, and the potential opportunity for greater centralisation and collaboration in the use of ECMO for the treatment of COVID-19-associated ARDS.
Study context
- Population
- Adults receiving venovenous extracorporeal membrane oxygenation (ECMO) for COVID-19-associated acute respiratory distress syndrome (ARDS)
- Participants
- 17,449 adults · 42 observational cohort studies
- Comparison
- Pre-cannulation prognostic factors and in-hospital mortality
- Outcome
- In-hospital mortality
Methodological detailsprognostic factor analysis, QUIPS risk of bias, GRADE certainty of evidence, MEDLINE and Embase searched Dec 1, 2019, to April 14, 2022; 2888 studies identified
- Prognostic factor analysis
- QUIPS risk of bias
- GRADE certainty of evidence
- MEDLINE and Embase searched Dec 1, 2019, to April 14, 2022; 2888 studies identified
Pooled result
As reported in the abstract
Factors with moderate or high certainty of association with increased mortality
Estimate (95% CI)
Older agepatient factor
aHR 2.27(1.63–3.16)
Chronic lung diseasepatient factor
aHR 1.55(1.20–2.00)
Higher driving pressurepre-cannulation disease factor
aHR 2.36(1.40–3.97)
Less previous ECMO experiencecentre factor
aOR 2.27(1.28–4.05)
Mean difference, days (95% CI)
Longer duration of symptomspre-cannulation disease factor
1.51(0.36–2.65)
Mean difference, mm Hg (95% CI)
Higher PaCO2pre-cannulation disease factor
4.04(1.64–6.44)
uOR
- Male sex · patient factor
- 1.34 (95% CI 1.20–1.49)
- Longer duration of invasive mechanical ventilation · pre-cannulation disease factor
- 1.94 (95% CI 1.40–2.67)
Original publication
Prognostic factors associated with mortality among patients receiving venovenous extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis. Lancet Respir Med. Published 10 October 2022. doi:10.
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