Unveiling Baseline Clinical Divergence in VA ECMO vs. ECPELLA: Tailoring Treatment for Distinct Patient Profiles. A Systematic Review and Meta-analysis
Authors' conclusion
Patients who received a combination of MCS and VA ECMO have a greater prevalence of comorbidities.
Study context
- Population
- Patients with cardiogenic shock receiving VA ECMO9 retrospective, 3 prospective, 2 RCTs
- Comparison
- ECPella vs VA ECMO alone or VA ECMO + intra-aortic balloon pump (IABP)
- Outcome
- Baseline characteristics, ECPella vs VA ECMO alone
Methodological details9 retrospective, 3 prospective and 2 RCTs; sample sizes 34 to 1,678
- 9 retrospective, 3 prospective and 2 RCTs; sample sizes 34 to 1,678
Pooled result
As reported in the abstract
Coronary artery disease prevalence
65.0% v 34.6%
P < 0.0001
ECPella
Cardiac arrest before mechanical circulatory support (MCS) implantation
63.1% v 52.7%
P < 0.0001
ECPella
Ischemic cardiogenic shock (CS)
53.1% v 42.6%
P < 0.0001
ECPella
Further pooled results
| Outcome | Estimate | P value |
|---|---|---|
| Baseline characteristics, ECPella vs VA ECMO + IABPECPella vs VA ECMO + IABP | Acute MI-CS 53.1% v 39.0% | P < 0.0001 |
| Baseline characteristics, ECPella vs VA ECMO + IABPECPella vs VA ECMO + IABP | Preimplantation cardiac arrest 63% v 49.3% | P < 0.0001 |
| Baseline characteristics, ECPella vs VA ECMO + IABPECPella vs VA ECMO + IABP | ECPR 25.8% v 20.0% | P = 0.0015 |
Comorbidities with the 2 RCTs included in VA ECMO group
- Inclusion of the 2 RCTs in the VA ECMO group increased comorbidity prevalence vs ECPella
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Unveiling Baseline Clinical Divergence in VA ECMO vs. ECPELLA: Tailoring Treatment for Distinct Patient Profiles. A Systematic Review and Meta-analysis. J Cardiothorac Vasc Anesth. Published 3 December 2024. doi:10.
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