Acute cardiac care & resuscitation
Exposure to severe hyperoxemia worsens survival and neurological outcome in patients supported by veno-arterial extracorporeal membrane oxygenation: A meta-analysis
Authors' conclusion
Severe hyperoxemia exposure after initiation of VA-ECMO may be associated with an almost doubled increased probability of poor neurological outcome and mortality.
Study context
- Population
- Patients supported by Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) for refractory cardiogenic shock or refractory cardiac arrest10 observational studies
- Comparison
- Severe hyperoxemia vs normal oxygenation during VA-ECMO
- Outcome
- Mortality and poor neurological outcome
Pooled result
As reported in the abstract
Mortality and poor neurological outcome
Severe hyperoxemia vs Normal oxygenationOdds ratio (95% CI)P value
Mortality; 9 studies; I2 = 83%; low certainty of evidence
1.80(1.16–2.78)
P = 0.009Poor neurological outcome; 4 studies; I2 = 0%; low certainty of evidence
1.97(1.30–2.96)
P = 0.001Further pooled results
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Studies with adjusted OR only — Severe hyperoxemia vs Normal oxygenation · poor neurological outcome; 3 studies | 2.11 (1.32–3.38) | P = 0.002 | |
| Studies with adjusted OR only — Severe hyperoxemia vs Normal oxygenation · mortality; 5 studies | 1.68 (0.89–3.18) | P = 0.11 | |
| 0.20.5125Odds ratio (log scale) |
Mortality, refractory cardiac arrest (CA) subgroup
- Association with mortality uncertain
- P = 0.13
- Findings otherwise consistent across hyperoxemia thresholds and VA-ECMO indication
Original publication
Exposure to severe hyperoxemia worsens survival and neurological outcome in patients supported by veno-arterial extracorporeal membrane oxygenation: A meta-analysis. Resuscitation. Published 5 December 2023. doi:10.
Summarised from the published abstract; every number is checked against it