Abstract
Objective
This systematic review and meta-analysis aimed to investigate the role of regional
cerebral oxygen saturation (rSO2) in predicting survival and neurological outcomes after extracorporeal cardiopulmonary
resuscitation (ECPR).
Design
We performed a systematic review and meta-analysis of all available literature.
Setting
We searched relevant databases (Pubmed/Medline, Embase) for studies measuring pre-cannulation
rSO2 in ECPR patients and reporting mortality and/or neurological outcomes.
Participants
We included both in-hospital and out-of-hospital cardiac arrest patients receiving
ECPR. We identified three observational studies including 245 adult patients.
Interventions
We compared patients with a low pre-cannulation rSO2 (≤ 15% or 16%) versus patients with a high (>15% or 16%) pre-cannulation rSO2. In addition, we carried out subgroup analyses on out-of-hospital cardiac arrest
(OHCA) patients.
Measurements and Main Results
A high pre-cannulation rSO2 was associated with a reduced risk of mortality in overall ECPR recipients (98/151
[64.9%] in the high rSO2 group vs 87/94 [92.5%] in the low rSO2 group, risk differences (RD) -0.30; 95% confidence interval (CI) [-0.47 to -0.14])
and in OHCA (78/121 [64.5%] vs 82/89 [92.1%], RD 0.30; 95% CI [-0.48 to -0.12]). A
high pre-cannulation rSO2 was also associated with a significantly better neurological outcome in the overall
population (42/151 [27.8%] vs 2/94 [2.12%], RD 0.22; 95% CI [0.13 to 0.31]) and in
OHCA patients (33/121 [27.3%] vs 2/89 [2.25%] RD 0.21; 95% CI [0.11 to 0.30]).
Conclusions
A low rSO2 before starting ECPR could be a predictor of mortality and survival with poor neurological
outcomes.
Keywords
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
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