Predictors of Survival and Favorable Neurologic Outcome in Patients Treated with eCPR: a Systematic Review and Meta-analysis

J Cardiovasc Transl Res. 2022 Apr;15(2):279-290. doi: 10.1007/s12265-021-10195-9. Epub 2022 Feb 22.

Abstract

Extracorporeal cardiopulmonary resuscitation (eCPR) can improve survival in selected patients with cardiac arrest (CA). In this meta-analysis, we evaluated factors associated with short-term survival and favorable neurologic outcome (FNO) post-eCPR. In June 2019, we systematically searched electronic databases for studies reporting on survival and predictors associated with short-term survival or FNO post-eCPR using multivariable analysis. We meta-analyzed outcomes and predictors using the inverse variance method with a random-effects model. We identified 92 studies with 13 factors amenable to meta-analysis. Pooled short-term survival and FNO were 25% and 16% respectively. Lower lactate, return of spontaneous circulation, shockable rhythm, shorter CPR duration, baseline pH, shorter low-flow time, and history of hypertension were significantly associated with short-term survival. In addition, shockable rhythm, lower lactate, and use of targeted temperature management were associated with FNO. The identified factors associated with short-term survival and FNO post-eCPR could guide prognosis prediction at the time of CA.

Keywords: CPR; Cardiac arrest; Cardiopulmonary resuscitation; ECMO; ECPR; Extracorporeal membrane oxygenation; MCS; Mechanical circulatory support; Resuscitation.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiopulmonary Resuscitation* / adverse effects
  • Cardiopulmonary Resuscitation* / methods
  • Extracorporeal Membrane Oxygenation*
  • Humans
  • Out-of-Hospital Cardiac Arrest*
  • Retrospective Studies
  • Treatment Outcome