Evidence map›Paper›PMID 36918967›Full record

SynthesisSystematic reviews2023

Predictive models in extracorporeal membrane oxygenation (ECMO): a systematic review.

Luca Giordano, Andrea Francavilla, Tomaso Bottio, Andrea Dell'Amore, Dario Gregori, Paolo Navalesi, Giulia Lorenzoni, Ileana Baldi

Full text readSystematic Review
In one paragraph

Synthesis in Systematic reviews, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Luca Giordano *Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy.
Andrea Francavilla *Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy.
Tomaso BottioThoracic Surgery Unit, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy.
Andrea Dell'AmoreThoracic Surgery Unit, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy.
Dario GregoriUnit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy.
Paolo NavalesiDepartment of Medicine (DIMED), Institute of Anesthesia and Intensive Care, University of Padova, Padova, Italy.
Giulia LorenzoniUnit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy.
Ileana BaldiUnit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121, Padova, Italy. ileana.baldi@unipd.it.ORCID 0000-0002-8578-9164

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeExtracorporeal membrane oxygenation (ECMO) has been increasingly used in the last years to provide hemodynamic and respiratory support in critically ill patients. In this scenario, prognostic scores remain essential to choose which patients should initiate ECMO. This systematic review aims to assess the current landscape and inform subsequent efforts in the development of risk prediction tools for ECMO.

methodsPubMed, CINAHL, Embase, MEDLINE and Scopus were consulted. Articles between Jan 2011 and Feb 2022, including adults undergoing ECMO reporting a newly developed and validated predictive model for mortality, were included. Studies based on animal models, systematic reviews, case reports and conference abstracts were excluded. Data extraction aimed to capture study characteristics, risk model characteristics and model performance. The risk of bias was evaluated through the prediction model risk-of-bias assessment tool (PROBAST). The protocol has been registered in Open Science Framework ( https://osf.io/fevw5 ).

resultsTwenty-six prognostic scores for in-hospital mortality were identified, with a study size ranging from 60 to 4557 patients. The most common candidate variables were age, lactate concentration, creatinine concentration, bilirubin concentration and days in mechanical ventilation prior to ECMO. Five out of 16 venous-arterial (VA)-ECMO scores and 3 out of 9 veno-venous (VV)-ECMO scores had been validated externally. Additionally, one score was developed for both VA and VV populations. No score was judged at low risk of bias.

conclusionMost models have not been validated externally and apply after ECMO initiation; thus, some uncertainty whether ECMO should be initiated still remains. It has yet to be determined whether and to what extent a new methodological perspective may enhance the performance of predictive models for ECMO, with the ultimate goal to implement a model that positively influences patient outcomes.

Indexed as

Extracorporeal Membrane OxygenationBiasHospital MortalityRisk AssessmentRisk FactorsECMOExtracorporeal membrane oxygenationMortalityPredictive modelsPredictive scores

Identifiers

PMID36918967
PMCPMC10015918

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.