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Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs. without left ventricular unloading by Impella: a systematic review and meta-analysis by Luigi Cappannoli; Mattia Galli; Andrea Zito; Attilio Restivo; Giuseppe Princi; Renzo Laborante; Rocco Vergallo; Enrico Romagnoli; Antonio Maria Leone; Cristina Aurigemma; Massimo Massetti; Tommaso Sanna; Carlo Trani; Francesco Burzotta; Gianluigi Savarese; Filippo Crea; Domenico D'Amario is a Medicine article available to read on EtoBox.

What is Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs. without left ventricular unloading by Impella: a systematic review and meta-analysis about?

## Abstract ## Background and aims The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for the treatment of cardiogenic shock (CS) may result in left ventricle overload and distension. Percutaneous microaxial flow pump Impella in addition to VA-ECMO (ECPELLA) is an emerging option to overcome these collateral effects. Aim of this study is to assess whether the addition of Impella to VA-ECMO is an effective and safe unloading strategy. ## Methods and results We performed a systematic literature review of studies comparing ECPELLA vs. ECMO alone in patients with CS. The primary endpoint was early mortality (in-hospital or 30-day mortality). The secondary endpoints were bleeding, need for kidney replacement therapy, haemolysis, infections, and limb ischaemia. A total of 3469 potentially relevant articles were screened and eight retrospective studies including 11.137 patients were selected. There was no significant difference in early mortality (Risk Ratio, RR 0.90, 95% CI 0.78–1.03) between ECPELLA and ECMO. Nevertheless, there was a borderline significant reduction in early mortality with ECPELLA (RR 0.74, 95% CI 0.55–1.00) at sensitivity analysis selectively includ

Who reads Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs. without left ventricular unloading by Impella: a systematic review and meta-analysis?

Author

Luigi Cappannoli; Mattia Galli; Andrea Zito; Attilio Restivo; Giuseppe Princi; Renzo Laborante; Rocco Vergallo; Enrico Romagnoli; Antonio Maria Leone; Cristina Aurigemma; Massimo Massetti; Tommaso Sanna; Carlo Trani; Francesco Burzotta; Gianluigi Savarese; Filippo Crea; Domenico D'Amario

Publisher

Oxford University Press (OUP)

Published

2022

Language

EN

Field

Medicine (Health Sciences)