Key result
IABP combined with VA-ECMO did not significantly reduce mortality compared to VA-ECMO alone (59.7% vs 65.8%; RR 0.90; 95% CI 0.80-1.02; P=0.107), although it improved weaning success.
Why the study?
The effectiveness of combining intra-aortic balloon pump with venoarterial extracorporeal membrane oxygenation in patients with cardiogenic shock or cardiac arrest remains controversial.
Does IABP combined with VA-ECMO reduce in-hospital mortality or improve weaning rates in patients with cardiogenic shock or cardiac arrest compared to VA-ECMO alone?
Comparison
IABP combined with VA-ECMO vs VA-ECMO alone
Design
Systematic review and meta-analysis of observational studies
Authors
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Does not support routine IABP addition to VA-ECMO for mortality reduction; confirms weaning benefit without survival gain.
Meta-Analysis (n=3,704)
Does IABP combined with VA-ECMO reduce in-hospital mortality or improve weaning rates in patients with cardiogenic shock or cardiac arrest compared to VA-ECMO alone?
Relative Risk: 0.9 (95% CI 0.8–1.02)
Absolute Event Rate: 59.7% vs 65.8%
p-value: p=0.107
Combining IABP with VA-ECMO in patients with cardiogenic shock or cardiac arrest improves the success rate of weaning from VA-ECMO but does not significantly reduce in-hospital mortality.
Wang et al. (2018) conducted a meta-analysis in Cardiogenic shock or cardiac arrest (n=3,704). Intra-aortic balloon pump (IABP) combined with venoarterial extracorporeal membrane oxygenation (VA-ECMO) vs. VA-ECMO alone was evaluated on Mortality (RR 0.90, 95% CI 0.80-1.02, p=0.107). IABP combined with VA-ECMO did not significantly reduce mortality compared to VA-ECMO alone (59.7% vs 65.8%; RR 0.90; 95% CI 0.80-1.02; P=0.107), although it improved weaning success.
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