ECMO for severe ARDS: systematic review and individual patient data meta-analysis.

Cross-Over Studies Extracorporeal Membrane Oxygenation Humans Randomized Controlled Trials as Topic Respiration, Artificial Respiratory Distress Syndrome / therapy Risk
Acute respiratory distress syndrome Adult patients Extracorporeal membrane oxygenation Individual patient data meta-analysis

Journal

Intensive care medicine
ISSN: 1432-1238
Titre abrégé: Intensive Care Med
Pays: United States
ID NLM: 7704851

Informations de publication

Date de publication:
11 2020
Historique:
received: 17 07 2020
accepted: 15 09 2020
pubmed: 7 10 2020
medline: 22 5 2021
entrez: 6 10 2020
Statut: ppublish

Résumé

To assess the effect of venovenous extracorporeal membrane oxygenation (ECMO) compared to conventional management in patients with severe acute respiratory distress syndrome (ARDS). We conducted a systematic review and individual patient data meta-analysis of randomised controlled trials (RCTs) performed after Jan 1, 2000 comparing ECMO to conventional management in patients with severe ARDS. The primary outcome was 90-day mortality. Primary analysis was by intent-to-treat. We identified two RCTs (CESAR and EOLIA) and combined data from 429 patients. On day 90, 77 of the 214 (36%) ECMO-group and 103 of the 215 (48%) control group patients had died (relative risk (RR), 0.75, 95% confidence interval (CI) 0.6-0.94; P = 0.013; I In this meta-analysis of individual patient data in severe ARDS, 90-day mortality was significantly lowered by ECMO compared with conventional management.

Identifiants

DOI: 10.1007/s00134-020-06248-3 PMID: 33021684 PMC: PMC7537368
pubmed: 33021684
doi: 10.1007/s00134-020-06248-3
pii: 10.1007/s00134-020-06248-3
pmc: PMC7537368
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2048-2057

Subventions

Organisme : Department of Health
ID : 99/01/01
Pays : United Kingdom

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Auteurs

Alain Combes (A)

Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, 75013, Paris, France. alain.combes@aphp.fr.
Service de médecine Intensive-réanimation, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université INSERM, UMRS_1166-ICA, Institute of Cardiometabolism and Nutrition, 47, boulevard de l'Hôpital, N75013, Paris, France. alain.combes@aphp.fr.
ORCID: 0000-0002-6030-3957

Giles J Peek (GJ)

Congenital Heart Center, Shands Children's Hospital, University of Florida, Gainesville, FL, 32610, USA.

David Hajage (D)

Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1421, 75013, Paris, France.

Pollyanna Hardy (P)

Birmingham Clinical Trials Unit, University of Birmingham, Edgbaston, B15 2TT, UK.

Darryl Abrams (D)

Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, NY, USA.
Center for Acute Respiratory Failure, Columbia University Medical Center, New York, NY, USA.

Matthieu Schmidt (M)

Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, 75013, Paris, France.
Service de médecine Intensive-réanimation, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université INSERM, UMRS_1166-ICA, Institute of Cardiometabolism and Nutrition, 47, boulevard de l'Hôpital, N75013, Paris, France.

Agnès Dechartres (A)

Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1421, 75013, Paris, France.

Diana Elbourne (D)

Medical Statistics Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Études croisées › ECMO for severe ARDS: systematic review and...
questionsmedicales.fr › Procédures de chirurgie opératoire › Circulation extracorporelle › Oxygénation extracorporelle sur oxygénateur à membrane › ECMO for severe ARDS: systematic review and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › ECMO for severe ARDS: systematic review and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › ECMO for severe ARDS: systematic review and...
questionsmedicales.fr › Thérapeutique › Thérapie respiratoire › Ventilation artificielle › ECMO for severe ARDS: systematic review and...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Troubles respiratoires › Syndrome de détresse respiratoire de l'adulte › ECMO for severe ARDS: systematic review and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › ECMO for severe ARDS: systematic review and...