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European Journal of Medical Research
Published in: European Journal of Medical Research 1/2024

Open Access 01-12-2024 | ECMO | Review

Extracorporeal membrane oxygenation technology for adults: an evidence mapping based on systematic reviews

Authors: Kai Xie, Hui Jing, Shengnan Guan, Xinxin Kong, Wenshuai Ji, Chen Du, Mingyan Jia, Haifeng Wang

Published in: European Journal of Medical Research | Issue 1/2024

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Abstract

Background

Extracorporeal membrane oxygenation (ECMO) is a cutting-edge life-support measure for patients with severe cardiac and pulmonary illnesses. Although there are several systematic reviews (SRs) about ECMO, it remains to be seen how quality they are and how efficacy and safe the information about ECMO they describe is in these SRs. Therefore, performing an overview of available SRs concerning ECMO is crucial.

Methods

We searched four electronic databases from inception to January 2023 to identify SRs with or without meta-analyses. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the methodological quality, and evidence quality for SRs, respectively. A bubble plot was used to visually display clinical topics, literature size, number of SRs, evidence quality, and an overall estimate of efficacy.

Results

A total of 17 SRs met eligibility criteria, which were combined into 9 different clinical topics. The methodological quality of the included SRs in this mapping was “Critically low” to “Moderate”. One of the SRs was high-quality evidence, three on moderate, three on low, and two on very low-quality evidence. The most prevalent study used to evaluate ECMO technology was observational or cohort study with frequently small sample sizes. ECMO has been proven beneficial for severe ARDS and ALI due to the H1N1 influenza infection. For ARDS, ALF or ACLF, and cardiac arrest were concluded to be probably beneficial. For dependent ARDS, ARF, ARF due to the H1N1 influenza pandemic, and cardiac arrest of cardiac origin came to an inconclusive conclusion. There was no evidence for a harmful association between ECMO and the range of clinical topics.

Conclusions

There is limited available evidence for ECMO that large sample, multi-center, and multinational RCTs are needed. Most clinical topics are reported as beneficial or probably beneficial of SRs for ECMO. Evidence mapping is a valuable and reliable methodology to identify and present the existing evidence about therapeutic interventions.
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Metadata
Title
Extracorporeal membrane oxygenation technology for adults: an evidence mapping based on systematic reviews
Authors
Kai Xie
Hui Jing
Shengnan Guan
Xinxin Kong
Wenshuai Ji
Chen Du
Mingyan Jia
Haifeng Wang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2024
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-024-01837-0

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