13 results on '"Ramanathan, Kollengode"'
Search Results
2. Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis
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Low, Christopher Jer Wei, Ling, Ryan Ruiyang, Ramanathan, Kollengode, Chen, Ying, Rochwerg, Bram, Kitamura, Tetsuhisa, Iwami, Taku, Ong, Marcus Eng Hock, and Okada, Yohei
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- 2024
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3. Extracorporeal membrane oxygenation in patients with hematologic malignancies: a systematic review and meta-analysis
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Sim, Jackie Jia Lin, Mitra, Saikat, Ling, Ryan Ruiyang, Tan, Chuen Seng, Fan, Bingwen Eugene, MacLaren, Graeme, and Ramanathan, Kollengode
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- 2022
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4. Evolving outcomes of extracorporeal membrane oxygenation during the first 2 years of the COVID-19 pandemic: a systematic review and meta-analysis
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Ling, Ryan Ruiyang, Ramanathan, Kollengode, Sim, Jackie Jia Lin, Wong, Suei Nee, Chen, Ying, Amin, Faizan, Fernando, Shannon M., Rochwerg, Bram, Fan, Eddy, Barbaro, Ryan P., MacLaren, Graeme, Shekar, Kiran, and Brodie, Daniel
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- 2022
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5. Extracorporeal Membrane Oxygenation for Pulmonary Embolism: A Systematic Review and Meta-Analysis.
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Boey, Jonathan Jia En, Dhundi, Ujwal, Ling, Ryan Ruiyang, Chiew, John Keong, Fong, Nicole Chui-Jiet, Chen, Ying, Hobohm, Lukas, Nair, Priya, Lorusso, Roberto, MacLaren, Graeme, and Ramanathan, Kollengode
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EXTRACORPOREAL membrane oxygenation ,PULMONARY embolism ,CARDIOGENIC shock ,HOSPITAL mortality ,HEART beat - Abstract
Background: The use of extracorporeal membrane oxygenation (ECMO) for high-risk pulmonary embolism (HRPE) with haemodynamic instability or profound cardiogenic shock has been reported. Guidelines currently support the use of ECMO only in patients with cardiac arrest or circulatory collapse and in conjunction with other curative therapies. We aimed to characterise the mortality of adults with HRPE treated with ECMO, identify factors associated with mortality, and compare different adjunct curative therapies. Methods: We conducted a systematic review and meta-analysis, searching four international databases from their inception until 25 June 2023 for studies reporting on more than five patients receiving ECMO for HRPE. Random-effects meta-analyses were conducted. The primary outcome was in-hospital mortality. A subgroup analysis investigating the outcomes with curative treatment for HRPE was also performed. The intra-study risk of bias and the certainty of evidence were also assessed. This study was registered with PROSPERO (CRD42022297518). Results: A total of 39 observational studies involving 6409 patients receiving ECMO for HRPE were included in the meta-analysis. The pooled mortality was 42.8% (95% confidence interval [CI]: 37.2% to 48.7%, moderate certainty). Patients treated with ECMO and catheter-directed therapy (28.6%) had significantly lower mortality (p < 0.0001) compared to those treated with ECMO and systemic thrombolysis (57.0%). Cardiac arrest prior to ECMO initiation (regression coefficient [B]: 1.77, 95%-CI: 0.29 to 3.25, p = 0.018) and pre-ECMO heart rate (B: −0.076, 95%-CI: −0.12 to 0.035, p = 0.0003) were significantly associated with mortality. The pooled risk ratio when comparing mortality between patients on ECMO and those not on ECMO was 1.51 (95%-CI: 1.07 to 2.14, p < 0.01) in favour of ECMO. The pooled mortality was 55.2% (95%-CI: 47.7% to 62.6%), using trim-and-fill analysis to account for the significant publication bias. Conclusions: More than 50% of patients receiving ECMO for HRPE survive. While outcomes may vary based on the curative therapy used, early ECMO should be considered as a stabilising measure when treating patients with HRPE. Patients treated concurrently with systemic thrombolysis have higher mortality than those receiving ECMO alone or with other curative therapies, particularly catheter-directed therapies. Further studies are required to explore ECMO vs. non-ECMO therapies in view of currently heterogenous datasets. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Blood Pressure Targets for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.
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Lim, Shir Lynn, Low, Christopher Jer Wei, Ling, Ryan Ruiyang, Sultana, Rehena, Yang, Victoria, Ong, Marcus E. H., Chia, Yew Woon, Sharma, Vijay Kumar, and Ramanathan, Kollengode
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BLOOD pressure ,CARDIAC arrest ,ACUTE kidney failure ,SEQUENTIAL analysis ,RANDOMIZED controlled trials - Abstract
Background: With ideal mean arterial pressure (MAP) targets in resuscitated out-of-hospital cardiac arrest (OHCA) patients unknown, we performed a meta-analysis of randomised controlled trials (RCTs) to compare the effects of higher versus lower MAP targets. Methods: We searched four databases until 1 May 2023 for RCTs reporting the effects of higher MAP targets (>70 mmHg) in resuscitated OHCA patients and conducted random-effects meta-analyses. The primary outcome was mortality while secondary outcomes were neurological evaluations, arrhythmias, acute kidney injury, and durations of mechanical ventilation and ICU stay. We conducted inverse-variance weighted strata-level meta-regression against a proportion of non-survivors to assess differences between reported MAPs. We also conducted a trial sequential analysis of RCTs. Results: Four RCTs were included. Higher MAP was not associated with reduced mortality (OR: 1.09, 95%-CI: 0.84 to 1.42, p = 0.51), or improved neurological outcomes (OR: 0.99, 95%-CI: 0.77 to 1.27, p = 0.92). Such findings were consistent despite additional sensitivity analyses. Our robust variance strata-level meta-regression revealed no significant associations between mean MAP and the proportion of non-survivors (B: 0.029, 95%-CI: −0.023 to 0.081, p = 0.162), and trial sequential analysis revealed no meaningful survival benefit for higher MAPs. Conclusions: A higher MAP target was not significantly associated with improved mortality and neurological outcomes in resuscitated OHCA patients. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Venovenous extracorporeal CO2 removal to support ultraprotective ventilation in moderate-severe acute respiratory distress syndrome: A systematic review and meta-analysis of the literature.
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Worku, Elliott, Brodie, Daniel, Ling, Ryan Ruiyang, Ramanathan, Kollengode, Combes, Alain, and Shekar, Kiran
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ADULT respiratory distress syndrome treatment ,HEMORRHAGE complications ,ARTIFICIAL blood circulation ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE ,CONFIDENCE intervals ,SYSTEMATIC reviews ,HEMOLYSIS & hemolysins ,RESPIRATORY measurements ,EXTRACORPOREAL membrane oxygenation ,MEDLINE ,STATISTICAL correlation ,DATA analysis software ,VENTILATION ,LONGITUDINAL method ,DISEASE complications - Abstract
Background: A strategy that limits tidal volumes and inspiratory pressures, improves outcomes in patients with the acute respiratory distress syndrome (ARDS). Extracorporeal carbon dioxide removal (ECCO
2 R) may facilitate ultra-protective ventilation. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of venovenous ECCO2 R in supporting ultra-protective ventilation in moderate-to-severe ARDS. Methods: MEDLINE and EMBASE were interrogated for studies (2000–2021) reporting venovenous ECCO2 R use in patients with moderate-to-severe ARDS. Studies reporting ≥10 adult patients in English language journals were included. Ventilatory parameters after 24 h of initiating ECCO2 R, device characteristics, and safety outcomes were collected. The primary outcome measure was the change in driving pressure at 24 h of ECCO2 R therapy in relation to baseline. Secondary outcomes included change in tidal volume, gas exchange, and safety data. Results: Ten studies reporting 421 patients (PaO2 :FiO2 141.03 mmHg) were included. Extracorporeal blood flow rates ranged from 0.35-1.5 L/min. Random effects modelling indicated a 3.56 cmH2 O reduction (95%-CI: 3.22–3.91) in driving pressure from baseline (p <.001) and a 1.89 mL/kg (95%-CI: 1.75–2.02, p <.001) reduction in tidal volume. Oxygenation, respiratory rate and PEEP remained unchanged. No significant interactions between driving pressure reduction and baseline driving pressure, partial pressure of arterial carbon dioxide or PaO2 :FiO2 ratio were identified in metaregression analysis. Bleeding and haemolysis were the commonest complications of therapy. Conclusions: Venovenous ECCO2 R permitted significant reductions in ∆P in patients with moderate-to-severe ARDS. Heterogeneity amongst studies and devices, a paucity of randomised controlled trials, and variable safety reporting calls for standardisation of outcome reporting. Prospective evaluation of optimal device operation and anticoagulation in high quality studies is required before further recommendations can be made. [ABSTRACT FROM AUTHOR]- Published
- 2023
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8. Microaxial Left Ventricular Assist Device in Cardiogenic Shock: A Systematic Review and Meta-Analysis.
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Tan, Shien Ru, Low, Christopher Jer Wei, Ng, Wei Lin, Ling, Ryan Ruiyang, Tan, Chuen Seng, Lim, Shir Lynn, Cherian, Robin, Lin, Weiqin, Shekar, Kiran, Mitra, Saikat, MacLaren, Graeme, and Ramanathan, Kollengode
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HEART assist devices ,CARDIOGENIC shock ,INTRA-aortic balloon counterpulsation ,EXTRACORPOREAL membrane oxygenation ,DEATH rate - Abstract
Microaxial left ventricular assist devices (LVAD) are increasingly used to support patients with cardiogenic shock; however, outcome results are limited to single-center studies, registry data and select reviews. We conducted a systematic review and meta-analysis, searching three databases for relevant studies reporting on microaxial LVAD use in adults with cardiogenic shock. We conducted a random-effects meta-analysis (DerSimonian and Laird) based on short-term mortality (primary outcome), long-term mortality and device complications (secondary outcomes). We assessed the risk of bias and certainty of evidence using the Joanna Briggs Institute and the GRADE approaches, respectively. A total of 63 observational studies (3896 patients), 6 propensity-score matched (PSM) studies and 2 randomized controlled trials (RCTs) were included (384 patients). The pooled short-term mortality from observational studies was 46.5% (95%-CI: 42.7–50.3%); this was 48.9% (95%-CI: 43.8–54.1%) amongst PSM studies and RCTs. The pooled mortality at 90 days, 6 months and 1 year was 41.8%, 51.1% and 54.3%, respectively. Hemolysis and access-site bleeding were the most common complications, each with a pooled incidence of around 20%. The reported mortality rate of microaxial LVADs was not significantly lower than extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pumps (IABP). Current evidence does not suggest any mortality benefit when compared to ECMO or IABP. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Convalescent Plasma for Patients Hospitalized With Coronavirus Disease 2019: A Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials.
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Ling, Ryan Ruiyang, Sim, Jackie Jia Lin, Tan, Felicia Liying, Tai, Bee Choo, Syn, Nicholas, Mucheli, Sharavan Sadasiv, Fan, Bingwen Eugene, Mitra, Saikat, and Ramanathan, Kollengode
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• Current evidence on convalescent plasma (CP) in COVID-19 suggests a lack of benefit. • We reviewed the literature to assess whether CP is futile. • From our analysis, there was a lack of mortality and clinical benefit. • It is likely that CP is futile in COVID-19, and further RCTs should not be conducted. Current evidence from randomized controlled trials (RCTs) and systematic reviews on the utility of convalescent plasma (CP) in patients with coronavirus disease 2019 (COVID-19) suggests a lack of benefit. We conducted an updated meta-analysis of RCTs with trial sequential analysis to investigate whether convalescent plasma is futile in reducing mortality in patients hospitalized with COVID-19. We searched 6 databases from December 1, 2019 to August 1, 2021 for RCTs comparing the use of CP with standard of care or transfusion of non-CP standard plasma in patients with COVID-19. The risk of bias was assessed using the Cochrane Risk-of-Bias 2 Tool. Random effects (DerSimonian and Laird) meta-analyses were conducted. The primary outcome was the aggregate risk for in-hospital mortality between both arms. We conducted a trial sequential analysis (TSA) based on the pooled relative risks (RRs) for in-hospital mortality. Secondary outcomes included the pooled RR for receipt of mechanical ventilation and mean difference in hospital length of stay. We included 18 RCTs (8702 CP, 7906 control). CP was not associated with a significant mortality benefit (RR: 0.95, 95%-CI: 0.86-1.04, P =.27, high certainty). Subgroup analysis did not find any significant differences (p interaction = 0.30) between patients who received CP within 8 days of symptom onset (RR: 0.97, 95%-CI: 0.79-1.19, P =.80), or after 8 days (RR: 0.79, 95%-CI: 0.57-1.10, P =.16). TSA based on a RR reduction of 10% from a baseline mortality of 20% found that CP was not effective, with the pooled effect within the boundary for futility. CP did not significantly reduce the requirement for mechanical ventilation (RR: 1.00, 95%-CI: 0.91-1.10, P =.99, moderate certainty) or hospital length of stay (+1.32, 95%-CI: -1.86 to +4.52, P =.42, low certainty). CP does not improve relevant clinical outcomes in patients with COVID-19, especially in severe disease. The pooled effect of mortality was within the boundary of futility, suggesting the lack of benefit of CP in patients hospitalized with COVID-19. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Direct oral anticoagulants in atrial fibrillation following cardiac surgery: a systematic review and meta-analysis with trial sequential analysis.
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Koh, Kylynn K., Ling, Ryan R., Tan, Shaun Y.S., Chen, Ying, Fan, Bingwen E., Shekar, Kiran, Sule, Jai A., Subbian, Senthil K., and Ramanathan, Kollengode
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ATRIAL fibrillation , *SEQUENTIAL analysis , *ORAL medication , *CARDIAC surgery , *PROPENSITY score matching , *TRANSIENT ischemic attack , *STROKE prevention , *HEMORRHAGE prevention , *STROKE , *META-analysis , *WARFARIN , *ORAL drug administration , *SYSTEMATIC reviews , *SURGICAL complications , *ANTICOAGULANTS , *HEMORRHAGE ,PREVENTION of surgical complications - Abstract
Background: Direct oral anticoagulants (DOACs) have been increasingly used as anticoagulation therapy in the postoperative period. However, their effectiveness in post-cardiac surgical atrial fibrillation is yet to be determined.Methods: We conducted a meta-analysis, searching three international databases from 1 January 2003 to 26 January 2022 for studies reporting on DOACs in at least 10 adult patients (>18 yr of age) with post-cardiac surgical atrial fibrillation. The primary outcomes were major neurological events and bleeding; secondary outcomes were mortality, hospital and ICU length of stay, cost, and other complications from therapy. We included studies of any design, including RCTs, cohort studies with and without propensity score matching methods, and single-armed case series.Results: Twelve studies (8587 DOACs; 8315 warfarin) were included in this meta-analysis. The incidences of postoperative bleeding and major neurological events with DOACs were 7.3% (95% confidence interval [CI]: 3.4-14.7%) and 2.2% (95% CI: 0.9-4.9%), respectively. The incidence of major neurological events was lower in high-risk patients, including those with hypertension and higher CHA2DS2-VASc score, whereas patients with prior transient ischaemic attack or stroke had higher incidence of bleeding. Trial sequential analysis revealed that the cumulative Z-curve crossed the conventional boundary of benefit. Compared with warfarin, DOACs reduced the risk of bleeding (relative risk [RR] 0.74; 95% CI: 0.62-0.89; P=0.0011) and major neurological events (RR 0.63; 95% CI: 0.48-0.83; P=0.0012) but not mortality (RR 1.02; 95% CI: 0.77-1.35; P=0.090).Conclusions: DOACs reduced bleeding and major neurological events in patients with post-cardiac surgical atrial fibrillation, appearing safer than warfarin in this context. However, which specific DOAC provides the most effective anticoagulation in this patient population needs further investigation.Clinical Trial Registration: PROSPERO CRD42021282777. [ABSTRACT FROM AUTHOR]- Published
- 2022
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11. Outcomes of Pediatric Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis.
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Farhat, Abdelaziz, Ling, Ryan Ruiyang, Jenks, Christopher L., Poon, Wynne Hsing, Yang, Isabelle Xiaorui, Li, Xilong, Liu, Yulun, Darnell-Bowens, Cindy, Ramanathan, Kollengode, Thiagarajan, Ravi R., and Raman, Lakshmi
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CARDIOPULMONARY resuscitation , *CHILD patients , *CARDIAC arrest , *HEART diseases , *DATA extraction , *INTENSIVE care units , *RESEARCH , *META-analysis , *RESEARCH methodology , *SYSTEMATIC reviews , *PEDIATRICS , *EXTRACORPOREAL membrane oxygenation , *MEDICAL cooperation , *EVALUATION research , *RISK assessment , *COMPARATIVE studies - Abstract
Objective: The goal of this work is to provide insight into survival and neurologic outcomes of pediatric patients supported with extracorporeal cardiopulmonary resuscitation.Data Sources: A systematic search of Embase, PubMed, Cochrane, Scopus, Google Scholar, and Web of Science was performed from January 1990 to May 2020.Study Selection: A comprehensive list of nonregistry studies with pediatric patients managed with extracorporeal cardiopulmonary resuscitation was included.Data Extraction: Study characteristics and outcome estimates were extracted from each article.Data Synthesis: Estimates were pooled using random-effects meta-analysis. Differences were estimated using subgroup meta-analysis and meta-regression. The Meta-analyses Of Observational Studies in Epidemiology guideline was followed and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation system. Twenty-eight studies (1,348 patients) were included. There was a steady increase in extracorporeal cardiopulmonary resuscitation occurrence rate from the 1990s until 2020. There were 32, 338, and 1,094 patients' articles published between 1990 and 2000, 2001 and 2010, and 2010 and 2020, respectively. More than 70% were cannulated for a primary cardiac arrest. Pediatric extracorporeal cardiopulmonary resuscitation patients had a 46% (CI 95% = 43-48%; p < 0.01) overall survival rate. The rate of survival with favorable neurologic outcome was 30% (CI 95% = 27-33%; p < 0.01).Conclusions: The use of extracorporeal cardiopulmonary resuscitation is rapidly expanding, particularly for children with underlying cardiac disease. An overall survival of 46% and favorable neurologic outcomes add credence to this emerging therapy. [ABSTRACT FROM AUTHOR]- Published
- 2021
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12. Vascular Complications of Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Regression Analysis.
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Deng Jia, Isabelle Xiaorui Yang, Ryan Ruiyang Ling, Nicholas Syn, Wynne Hsing Poon, Kavita Murughan, Chuen Seng Tan, Choong, Andrew M. T. L., MacLaren, Graeme, Ramanathan, Kollengode, Jia, Deng, Yang, Isabelle Xiaorui, Ling, Ryan Ruiyang, Syn, Nicholas, Poon, Wynne Hsing, Murughan, Kavita, and Tan, Chuen Seng
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EXTRACORPOREAL membrane oxygenation , *PROGNOSIS , *DATA extraction , *HOSPITAL mortality , *META-analysis , *SYSTEMATIC reviews , *VASCULAR diseases ,VASCULAR disease diagnosis - Abstract
Objectives: Perform a systematic review and meta-analysis of vascular complications associated with extracorporeal membrane oxygenation and identify prognostic and predictive factors.Data Sources: Systematic search for publications reporting vascular complications on extracorporeal membrane oxygenation, published from 1972 to January 31, 2020, was conducted via PubMed, Scopus, and Embase.Study Selection: Of 4,076 references screened, 47 studies with 6,583 patients were included in final analyses. Studies with fewer than 10 patients were excluded.Data Extraction: Relevant data, including demographics, comorbidities, extracorporeal membrane oxygenation and cannulation characteristics, occurrence rates of early and late vascular complications, patient outcomes, and use of distal perfusion cannula, were extracted from selected articles into an excel sheet specifically designed for this review.Data Synthesis: Random-effects meta-analyses and meta-regression analyses were undertaken. Overall pooled estimate of vascular complications in our meta-analysis was 29.5% (95% CI, 23.6-35.9%). Two-thousand three-hundred forty-seven vascular complications in 6,124 venoarterial extracorporeal membrane oxygenation patients compared with 95 in 459 venovenous extracorporeal membrane oxygenation patients (odds ratio, 2.35; 95% CI, 1.87-2.96; p < 0.0001) were analyzed. Successful weaning off extracorporeal membrane oxygenation occurred in 60.6% of pooled patients; 46.2% were eventually discharged. Pooled prevalences of vascular complications like significant bleeding, limb ischemia, and cannula site bleeding were 15.4% (95% CI, 8.6-23.7%), 12.6% (95% CI, 10.0-15.5%), and 12.6% (95% CI, 9.6-18.5%), respectively. Meta-analysis showed that the use of distal perfusion cannula was associated with lower odds of limb ischemia (odds ratio, 1.93; 95% CI, 1.17-2.47; p = 0.03) Meta-regression showed that male sex, smoking, advanced age, and comorbidities contributed to higher in-hospital mortality, while distal perfusion cannula was protective.Conclusions: Nearly a third of patients on extracorporeal membrane oxygenation develop vascular complications; elderly males with comorbidities appear vulnerable. The use of distal perfusion cannulas caused significant reduction in limb ischemia and mortality. [ABSTRACT FROM AUTHOR]- Published
- 2020
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13. Role of extracorporeal membrane oxygenation in children with sepsis: a systematic review and meta-analysis
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Ryan P. Barbaro, Nicholas Yeo, Peta M. A. Alexander, Kollengode Ramanathan, Chuen Seng Tan, Luregn J. Schlapbach, Lakshmi Raman, Graeme MacLaren, University of Zurich, and Ramanathan, Kollengode
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Male ,medicine.medical_specialty ,Adolescent ,Critical Care ,medicine.medical_treatment ,Salvage therapy ,610 Medicine & health ,Subgroup analysis ,Critical Care and Intensive Care Medicine ,law.invention ,Sepsis ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,law ,Neonatal ,Septic shock ,Extracorporeal membrane oxygenation ,medicine ,Humans ,030212 general & internal medicine ,Child ,Pediatric ,business.industry ,Research ,Infant, Newborn ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Infant ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,medicine.disease ,Intensive care unit ,Survival Rate ,surgical procedures, operative ,10036 Medical Clinic ,Child, Preschool ,Meta-analysis ,Emergency medicine ,Cohort ,Female ,2706 Critical Care and Intensive Care Medicine ,business - Abstract
BackgroundThe benefits of extracorporeal membrane oxygenation (ECMO) in children with sepsis remain controversial. Current guidelines on management of septic shock in children recommend consideration of ECMO as salvage therapy. We sought to review peer-reviewed publications on effectiveness of ECMO in children with sepsis.MethodsStudies reporting on mortality in children with sepsis supported with ECMO, published in PubMed, Scopus and Embase from 1972 till February 2020, were included in the review. This study was done in adherence to Preferred Reporting Items for Systematic Review and Meta-Analysis statement after registering the review protocol with PROSPERO. Study eligibility was independently assessed by two authors and disagreements resolved by a third author. Publications were reviewed for quality using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Random-effects meta-analyses (DerSimonian and Laird) were conducted, and 95% confidence intervals were computed using the Clopper-Pearson method. Outliers were identified by the Baujat plot and leave-one-out analysis if there was considerable heterogeneity. The primary outcome measure was survival to discharge. Secondary outcome measures included hospital length of stay, subgroup analysis of neonatal and paediatric groups, types and duration of ECMO and complications .ResultsOf the 2054 articles screened, we identified 23 original articles for systematic review and meta-analysis. Cumulative estimate of survival (13 studies, 2559 patients) in the cohort was 59% (95%CI: 51–67%). Patients had a median length of hospital stay of 28.8 days, median intensive care unit stay of 13.5 days, and median ECMO duration of 129 h. Children needing venoarterial ECMO (9 studies, 208 patients) showed overall pooled survival of 65% (95%CI: 50–80%). Neonates (ConclusionSurvival rates of children with sepsis needing ECMO was 59%. Neonates had higher survival rates (73%); gram positive organisms accounted for most common infections in children needing ECMO. Despite limitations, pooled survival data from this review indicates consideration of ECMO in refractory septic shock for all pediatric age groups.
- Published
- 2020
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