פוסט זה זמין גם ב:
עברית
Review
Mathias J. Holmberga,b , Guillaume Geric,d , Sebastian Wibergb,e , Anne-Marie Guerguerianf ,
Michael W. Donninob,g , Jerry P. Nolanh , Charles D. Deakini , Lars W. Andersena,b,⁎ , for the
International Liaison Committee on Resuscitation’s (ILCOR) Advanced Life Support and Pediatric
Task Forces
Aim: To assess the use of extracorporeal cardiopulmonary resuscitation (ECPR), compared with manual ormechanical cardiopulmonary resuscitation (CPR), for out-of-hospital cardiac arrest (OHCA) and in-hospital
cardiac arrest (IHCA) in adults and children.
Methods: The PRISMA guidelines were followed. We searched Medline, Embase, and Evidence-Based Medicine
Reviews for randomized clinical trials and observational studies published before May 22, 2018. The population
included adult and pediatric patients with OHCA and IHCA of any origin. Two investigators reviewed studies for
relevance, extracted data, and assessed risk of bias using the ROBINS-I tool. Outcomes included short-term and
long-term survival and favorable neurological outcome.
Results: We included 25 observational studies, of which 15 studies were in adult OHCA, 7 studies were in adult
IHCA, and 3 studies were in pediatric IHCA. There were no studies in pediatric OHCA. No randomized trials were
included. Results from individual studies were largely inconsistent, although several studies in adult and pediatric IHCA were in favor of ECPR. The risk of bias for individual studies was overall assessed to be critical, with
confounding being the primary source of bias. The overall quality of evidence was assessed to be very low.
Heterogeneity across studies precluded any meaningful meta-analyses.