PMID- 35065202
OWN - NLM
STAT- MEDLINE
DCOM- 20220425
LR  - 20220425
IS  - 1096-1186 (Electronic)
IS  - 1043-6618 (Linking)
VI  - 177
DP  - 2022 Mar
TI  - Bivalirudin versus heparin in adult and pediatric patients with extracorporeal 
      membrane oxygenation therapy: A systematic review and meta-analysis.
PG  - 106089
LID - S1043-6618(22)00034-2 [pii]
LID - 10.1016/j.phrs.2022.106089 [doi]
AB  - BACKGROUND: Our study sought to investigate the efficacy and safety of 
      bivalirudin versus those of unfractionated heparin (UFH) in patients undergoing 
      extracorporeal membrane oxygenation (ECMO). METHODS: PubMed, EMBASE and Cochrane 
      Library were searched for studies enrolling ECMO patients on bivalirudin and UFH 
      (from inception till July 2021). Meta-analysis was conducted. The I(2) statistic 
      and p value were used in measuring heterogeneity, and random effects or 
      fixed-effect model was adopted. The Newcastle-Ottawa Scale was used for the risk 
      of bias assessment. Sensitivity and subgroup analyses were undertaken. We 
      performed Egger's test to evaluate publication bias. RESULTS: Fourteen eligible 
      retrospective observational studies with 1501 subjects were identified. Compared 
      with UFH, bivalirudin significantly reduced the risk of in-circuit thrombosis (OR 
      = 0.44, 95% CI [0.31-0.61], p = 0.000), thrombosis (OR = 0.61, 95% CI 
      [0.45-0.83], p= 0.002) and hospital mortality (OR = 0.78, 95% CI [0.61-0.99], 
      p = 0.04) and had a positive impact on survival ECMO (OR = 1.50, 95% CI 
      [1.04-2.16], p= 0.032). Decrease in risk of bleeding (OR = 0.36, 95% CI 
      [0.14-0.91], p = 0.031) associated with bivalirudin was observed. Sources of 
      heterogeneity were identified, and sensitivity analysis revealed similar results. 
      CONCLUSION: Our meta-analysis suggested that bivalirudin was associated with the 
      decreased risk of in-circuit thrombosis, thrombosis, hospital mortality and 
      bleeding in patients on ECMO and improved survival ECMO, indicating the 
      superiority of bivalirudin to UFH in terms of efficacy and safety.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Liu, Liyao
AU  - Liu L
AD  - The Department of Emergency & Critical Care Medicine, The First Affiliated 
      Hospital of Chongqing Medical University, Chongqing, China.
FAU - Liu, Feng
AU  - Liu F
AD  - The Department of Emergency & Critical Care Medicine, The First Affiliated 
      Hospital of Chongqing Medical University, Chongqing, China.
FAU - Tan, Jixiang
AU  - Tan J
AD  - The Department of Emergency & Critical Care Medicine, The First Affiliated 
      Hospital of Chongqing Medical University, Chongqing, China. Electronic address: 
      tanjixiang613@sohu.com.
FAU - Zhao, Lin
AU  - Zhao L
AD  - The Department of Emergency & Critical Care Medicine, The First Affiliated 
      Hospital of Chongqing Medical University, Chongqing, China. Electronic address: 
      zhaolin@cqmu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220120
PL  - Netherlands
TA  - Pharmacol Res
JT  - Pharmacological research
JID - 8907422
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/adverse effects
MH  - Child
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Hemorrhage/chemically induced
MH  - Heparin/adverse effects
MH  - Hirudins
MH  - Humans
MH  - Peptide Fragments/adverse effects
MH  - Recombinant Proteins/adverse effects
MH  - Retrospective Studies
MH  - *Thrombosis/drug therapy/prevention & control
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Bleeding
OT  - Cardiorespiratory failure
OT  - Mortality
OT  - Thrombosis
EDAT- 2022/01/23 06:00
MHDA- 2022/04/26 06:00
CRDT- 2022/01/22 20:09
PHST- 2021/11/30 00:00 [received]
PHST- 2022/01/16 00:00 [revised]
PHST- 2022/01/17 00:00 [accepted]
PHST- 2022/01/23 06:00 [pubmed]
PHST- 2022/04/26 06:00 [medline]
PHST- 2022/01/22 20:09 [entrez]
AID - S1043-6618(22)00034-2 [pii]
AID - 10.1016/j.phrs.2022.106089 [doi]
PST - ppublish
SO  - Pharmacol Res. 2022 Mar;177:106089. doi: 10.1016/j.phrs.2022.106089. Epub 2022 
      Jan 20.