Nutritional Support for ICU Patients Receiving Extracorporeal Membrane Oxygenation Therapy: A Meta-Analysis

Abstract Background ECMO constitutes a mechanical technique that provides extracorporeal gas exchange or/and circulatory support for patients with refractory life-threatening pulmonary or/ and cardiac failure. There is infrequent evidence regarding the optimal nutritional management and related clinical outcomes for adult critically-ill patients receiving ECMO. Objective This study was conducted to evaluate the effect of nutritional intervention on clinical outcomes in adult critically ill patients receiving Extracorporeal Membrane Oxygenation Therapy. Methodology Advanced search was conducted in Medline, PubMed, google scholar and the Egyptian Knowledge Bank for cohort studies that were published in English until September 2020. Inclusion Criteria cohort studies which assess nutrition support in adult critically-ill patients receiving ECMO therapy, and include at least one of these outcomes a) 28-day mortality, b) length of ICU stay, C) duration of mechanical ventilation and d) incidence of infection. Exclusion Criteria duplicate reports, Abstracts, case reports, case series, review articles, editorials and clinical guidelines. In addition, studies with unavailable full text or studies with different outcomes were excluded. Results 7 studies with a total number of 2358 patients were included in the meta-analysis. Estimates and their 95% confidence intervals (CI) were calculated, then pooled for analysis. Nutrition support in adult critically ill patients receiving ECMO was significantly related to 28-day mortality ( 95% CI 0.428 = 0.329–0.527; p 0.001), increased ICU length of stay ( 95% CI 29.512 (22.930–36.095), and P value 0.001), duration of mechanical ventilation (95% CI 17.985 = 4.682–31.288; p 0.008) and incidence of infection ( 95% CI 0.105 ( 0.066 – 0.144), and P value 0.001). Conclusion The study indicates positive association between effective nutrition support and clinical outcomes for adult critically-ill patients receiving ECMO therapy.