PMID- 36037805
OWN - NLM
STAT- MEDLINE
DCOM- 20230227
LR  - 20230228
IS  - 1421-9735 (Electronic)
IS  - 0253-5068 (Linking)
VI  - 52
IP  - 2
DP  - 2023
TI  - Extracorporeal Carbon Dioxide Removal in Patients with Acute Respiratory Distress 
      Syndrome or Chronic Obstructive Pulmonary Disease: A Systematic Review and 
      Meta-Analysis.
PG  - 103-113
LID - 10.1159/000525983 [doi]
AB  - BACKGROUND: Extracorporeal carbon dioxide removal (ECCO2R) was used to prevent 
      invasive mechanical ventilation and associated mechanical damage in patients with 
      acute respiratory distress syndrome (ARDS). OBJECTIVES: This study aimed to 
      investigate the efficacy and safety of ECCO2R treatment in patients with ARDS or 
      chronic obstructive pulmonary disease (COPD). METHODS: MEDLINE, EMBASE, and the 
      Cochrane Library were systematically searched for relevant studies that reported 
      patient prognosis, blood gas parameters, and ECCO2R-related adverse events (AEs) 
      published as of September 2020. Odds ratios (ORs), weighted mean differences 
      (WMDs), and their corresponding 95% confidence intervals (CIs) were used to 
      compare the outcomes. RESULTS: Fifteen studies involving 532 ARDS or COPD 
      patients were included. Compared with controls, ECCO2R did not influence the 
      28-day mortality (OR = 0.73, 95% CI: 0.28-1.87, p = 0.51), the length of hospital 
      stay (WMD = 3.34, 95% CI: -5.22 to 11.90, p = 0.444), and the length of intensive 
      care unit stay (WMD = -0.39, 95% CI: -8.76 to 7.99, p = 0.928). Compared with 
      baseline values, partial pressure of carbon dioxide (PaCO2) in the ECCO2R group 
      was significantly reduced, while the ratio of arterial oxygen partial pressure to 
      fractional inspired oxygen (PaO2/FiO2) and pH increased. The overall rate of 
      ECCO2R-related AEs was 35% (95% CI: 17-53%, p < 0.001), and bleeding was the most 
      common AE with a rate of 22% (95% CI: 13-31%, p = 0.002). The rate of 
      ECCO2R-related deaths was low. CONCLUSIONS: In conclusion, there was no 
      statistically significant difference in the prognosis of patients with and 
      without ECCO2R treatment. ECCO2R significantly reduced PaCO2 and improved 
      PaO2/FiO2 and pH values in patients with ARDS or COPD. Bleeding was the most 
      common ECCO2R-related AE.
CI  - (c) 2022 S. Karger AG, Basel.
FAU - Zhu, Yu
AU  - Zhu Y
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
FAU - Zhen, Weifeng
AU  - Zhen W
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
FAU - Zhang, Xiaoning
AU  - Zhang X
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
FAU - Shi, Zhenhua
AU  - Shi Z
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
FAU - Zhang, Ling
AU  - Zhang L
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
FAU - Zhou, Jiuju
AU  - Zhou J
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
FAU - Meng, Xiangzhong
AU  - Meng X
AD  - Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220829
PL  - Switzerland
TA  - Blood Purif
JT  - Blood purification
JID - 8402040
RN  - 142M471B3J (Carbon Dioxide)
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Humans
MH  - Carbon Dioxide
MH  - Respiration, Artificial/adverse effects
MH  - *Respiratory Distress Syndrome/etiology
MH  - *Pulmonary Disease, Chronic Obstructive/etiology/therapy
MH  - Oxygen
OTO - NOTNLM
OT  - Carbon dioxide partial pressure
OT  - Extracorporeal carbon dioxide removal
OT  - Hypercapnic respiratory failure
OT  - Meta-analysis
OT  - Safety
EDAT- 2022/08/30 06:00
MHDA- 2023/03/03 06:00
CRDT- 2022/08/29 18:32
PHST- 2021/11/01 00:00 [received]
PHST- 2022/06/27 00:00 [accepted]
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2022/08/29 18:32 [entrez]
AID - 000525983 [pii]
AID - 10.1159/000525983 [doi]
PST - ppublish
SO  - Blood Purif. 2023;52(2):103-113. doi: 10.1159/000525983. Epub 2022 Aug 29.