Acute cardiac care & resuscitation
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs. without left ventricular unloading by Impella: a systematic review and meta-analysis
Pooled result · Early mortalityResult — go to the resultRelative risk 0.90 95% CI 0.78–1.03Authors' conclusion
Among patients with cardiogenic shock, ECPELLA is associated with increased complications compared with ECMO.
Study context
- Population
- Patients with cardiogenic shock treated with VA-ECMO
- Participants
- 11.137 patients8 retrospective studies
- Comparison
- ECPELLA vs ECMO alone
- Outcome
- Early mortality (in-hospital or 30-day mortality)
Pooled result
Early mortality
Relative risk
0.90
95% CI 0.78–1.03
ECPELLAvs ECMO
RR 0.90 (95% CI 0.78–1.03)
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Early mortality, sensitivity analysis of propensity matched studiesBorderline significant reduction | 0.74 (0.55–1.00) | |
| 0.512Relative risk (log scale) |
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Bleeding | 1.45 (1.20–1.75) | |
| Need for kidney replacement therapy | 1.54 (1.19–1.99) | |
| Haemolysis | 1.71 (1.41–2.07) | |
| Limb ischaemia | 1.43 (1.17–1.75) | |
| Severe infectionsNon-significant increase | 1.26 (0.84–1.89) | |
| 0.512Relative risk (log scale) |
Original publication
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs. without left ventricular unloading by Impella: a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. Published 12 November 2022. doi:10.
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