Introduction
Review
Design
Study selection
Data extraction
Assessment of methodological quality
Search results
Characteristics of included studies
Study | Year |
N
| Intervention | Control | Mean agea | Male/ femalea | Primary outcome measure | Secondary outcome measures | VFDb | Mortalityc | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
I | C | P value | I | C | P value | |||||||||
Bein and colleagues [19] | 2013 | 79 | iLA | ARDSnet ventilation | 49.8 ± 12 (48.7 ± 17) | 38/2 (30/9) | Ventilator-free days (28 and 60 days) | Respiratory parameters, haemodynamics, inflammatory response, transfusion requirements, analgesic/sedative requirements, catecholamine requirements, frequency and duration of RRT, organ failure-free days, frequency and duration of adjunctive therapies, complications, ICU and hospital LOS, in-hospital mortality | 10 ± 8 (33.2 ± 20) | 9.3 ± 9 (29.2 ± 21) | 0.779 (0.469) | 7/40 (17.5%) | 6/39 (15.4%) | 0.000 |
Morris and colleagues [18] | 1994 | 40 | PCIRV then LFPPV + VV ECCO2R | Standardised CPPV | 33 ± 3.1 (35 ± 2.3) | 8/13 (9/10) | 30-day mortality | Respiratory parameters, transfusion requirements, complications, ICU and hospital LOS, economic analysis | NR | 14/21 (66.6%) | 11/19 (57.9%) | 0.56 |
Study | Design | Year |
N
| Intervention | Mean age (years) | Male/ female | Outcomes measured | Mortality (%) | Grade |
---|---|---|---|---|---|---|---|---|---|
Forster and colleagues [25] | Prospective case series | 2013 | 10 | VV (with CRRT) | 60 | 7/3 | Respiratory and haemodynamic parameters, complications, mortality | 40 | 3 |
Nierhaus and colleagues [29] | Retrospective case series | 2011 | 13 | AV | 52 | 8/5 | Respiratory parameters, ICU LOS, complications, mortality | 54 | 3 |
Weber-Carstens and colleagues [26] | Retrospective case series | 2009 | 10 | AV | 54 | 6/4 | Respiratory parameters, sedation scores, ICU LOS, mortality | 60 | 3 |
Zimmermann and colleagues [20] | Prospective case series | 2009 | 51 | AV | 52 | 43/8 | Respiratory parameters, haemodynamics, complications, mortality | 49 | 3 |
Terragni and colleagues [21] | Prospective cross-sectional study | 2009 | 32 | VV | 66 | 22/10 | Respiratory parameters, lung morphology, inflammatory response, complications | NR | 2+ |
Muellenbach and colleagues [27] | Retrospective case series | 2008 | 22 | AV | 38 | 20/2 | Respiratory parameters, haemodynamics, complications, ventilator-free days, ICU LOS, mortality | 27 | 3 |
Bein and colleagues [28] | Retrospective case series | 2006 | 90 | AV | 44 | 69/21 | Respiratory parameters, haemodynamics, complications, mortality | 59 | 3 |
Liebold and colleagues [30] | Retrospective case series | 2002 | 70 | AV | 41 | 55/15 | Respiratory parameters, complications, mortality | 64 | 3 |
Guinard and colleagues [22] | Prospective cross-sectional study | 1997 | 10 | VV | NR | NR | Respiratory parameters, complications, mortality | 75 | 2+ |
Brunet and colleagues [23] | Prospective case series | 1994 | 11 | VV | 27 | 4/7 | Respiratory parameters, mortality | 27 | 3 |
Bindslev and colleagues [31] | Retrospective case series | 1991 | 14 | VV | 31 | 11/3 | Respiratory parameters, complications, mortality | 57 | 3 |
Gattinoni and colleagues [24] | Prospective case series | 1986 | 43 | VV | 26 | 18/25 | Respiratory parameters, haemodynamics, complications, mortality | 51 | 3 |
Total | 376 | 263/103(+10 NR) |
Risk of bias in included studies
Effect of interventions
Primary outcome
Secondary outcomes
Ventilator-free days
Duration of ICU stay and organ failure-free days
Respiratory parameters including carbon dioxide removal
Study | Time | PaCO2change (mmHg) | Change in PaO2/FiO2(mmHg) | Pplat change (mmHg) | Vtreduction | pH change |
---|---|---|---|---|---|---|
Forster and colleagues [25] | 4 hours | 68.00 ± 8.28 to 49.6 ± 6.18 | NR | 19.8 ± 2.0 to 19.0 ± 2.4 | 8.41 ± 0.30 to 8.34 ± 1.04 | 7.18 ± 0.08 to 7.30 ± 0.07 |
Nierhaus and colleagues [29] | Day 1 | 80.0 ± 23.0 to 54.0 ± 19.0 | 100.0 ± 28.9 to 120.7 ± 51.2 | 34.0 ± 3.0b to 28.3 ± 4.0 | 292.5 ± 94.0a to 183.0 ± 67.0 | 7.18 ± 0.22 to 7.37 ± 0.09 |
Weber-Carstens and colleagues [26] | NR | 120 (81.9 to 152.5) to 60.3 (52.5 to 69) | 121.5 (79.3 to 178.3) to 87 (73 to 139.3) | 39 (34.8 to 43.3) to 31.5 (28.8 to 33.5) | 5.2 (4.4 to 5.9) to 3.5 (3.1 to 4.3)b | 7.06 (6.9 to 7.3) to 7.38 (7.18 to 7.48) |
Zimmermann and colleagues [20] | 24 hours | 73 (61 to 86) to 41 (34 to 48) | 75 (62 to 130) to 110 (86 to 160) | 35 (31 to 38) to 30 (26 to 34) | 6.6 (5.3 to 7.2) to 4.4 (3.4 to 5.4)b | 7.23 (7.16 to 7.30) to 7.44 (7.37 to 7.45) |
Terragni and colleagues [21] | NR | 47.2 ± 8.6 to 73.6 ± 11.1 | NR | NR | NR | 7.20 ± 0.02 to 7.38 ± 0.04 |
Muellenbach and colleagues [27] | 12 hours | 65.26 (54 to 72) to 39.8 (36 to 42) | 61.6 (47.3 to 85.6) to 135.8 (87.8 to 153) | NR | 450 (400 to 542.5) to 200 (145 to 250)a | 7.25 (7.22 to 7.29) to 7.4 (7.37 to 7.42) |
Bein and colleagues [28] | 24 hours | 60 (48 to 80) to 34 (30 to 39) | 58 (47 to 78) to 107 (74 to 142) | NR | 430 (360 to 540) to 380 (320 to 470)a | 7.27 (7.18 to 7.36) to 7.45 (7.41 to 7.50) |
Liebold and colleagues [30] | 24 hours | 59 ± 17 to 32 ± 8 | 50 to 110 | NR | NR | NR |
Guinard and colleagues [22] | NR | NR | NR | NR | NR | NR |
Brunet and colleagues [23] | NR | 66 ± 25 to 43 ± 6 | 79 ± 21 to 207 ± 108 | 48 ± 10 to 37 ± 5 | 622 ± 131 to 270 ± 60a | NR |
Bindslev and colleagues [31] | NR | NR | NR | NR | NR | NR |
Gattinoni and colleagues [24] | NR | NR | NR | NR | NR | NR |
Complications
Study | Year | Modality | Complication rate (%) | Description |
---|---|---|---|---|
Forster and colleagues [25] | 2013 | VV (with CRRT) | Nil | |
Bein and colleagues [19] | 2013 | AV | 7.5 | 1× lower limb ischaemia, 2× aneurysm |
Nierhaus and colleagues [29] | 2011 | AV | 21.4 | 2× catheter displacement, 1× bleeding at insertion site |
Weber-Carstens and colleagues [26] | 2009 | AV | 6.3 | 1× transient occlusion of femoral artery during cannulation |
Zimmermann and colleagues [20] | 2009 | AV | 11.8 | 3× lower limb ischaemia, 1× cannula thrombosis, 1× bleeding during cannulation, 1× compartment syndrome |
Terragni and colleagues [21] | 2009 | VV | 25 | 1× pump malfunction, 3× membrane/haemofilter clotting, 1× catheter displacement, 3× cannula problems |
Muellenbach and colleagues [27] | 2008 | AV | 23 | 2× lower limb ischaemia, 1× femoral artery pseudoaneurysm, 1× lower limb amputation, 1× catheter displacement |
Bein and colleagues [28] | 2006 | AV | 24.4 | 9× lower limb ischaemia, 4× cannula thrombosis, 4× compartment syndrome, 2× aneurysm, 1× haemolysis, 1× intracerebral haemorrhage, 1× diffuse bleeding with shock on cannulation |
Liebold and colleagues [30] | 2002 | AV | 21 | 7× cannula thrombosis, 1× membrane clotting, 3× lower limb ischaemia, 5× membrane plasma leakage |
Guinard and colleagues [22] | 1997 | VV | NR | NR |
Morris and colleagues [18] | 1994 | VV | NR | 21× non-CNS haemorrhage (7 requiring discontinuation of ECCO2R), 4× circuit clotting |
Brunet and colleagues [23] | 1994 | VV | 18.2 | 1× alveolar haemorrhage, 1× diffuse bleeding |
Bindslev and colleagues [31] | 1991 | VV | NR | 1× allergic reaction |
Gattinoni and colleagues [24] | 1986 | VV | NR | 3× intra-pulmonary bleeding |