Evidence map›Paper›PMID 40106427›Full record

SynthesisPloS one2025

Predictors of successful weaning from veno-arterial extracorporeal membrane oxygenation (V-A ECMO): A systematic review and meta-analysis.

Henry R Hsu, Praba Sekhar, Jahnavi Grover, David H Tian, Ciaran Downey, Ben Maudlin, Chathuri Dissanayake, Mark Dennis

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
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.

Henry R HsuSchool of Medicine, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0009-0001-8733-1309
Praba SekharDepartment of Anaesthesia and Perioperative Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
Jahnavi GroverSchool of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
David H TianDepartment of Anaesthesia and Perioperative Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
Ciaran DowneyDepartment of Anaesthesia, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Ben MaudlinSchool of Medicine, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-3048-8046
Chathuri DissanayakeDepartment of Intensive Care, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Mark DennisSchool of Medicine, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-1281-1324

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVenoarterial extracorporeal membrane oxygenation (V-A ECMO) use to support patients in cardiac failure is increasing. Despite this increased use, predicting successful weaning from ECMO can be challenging, no uniform guidelines on weaning exist. Therefore, we completed a systematic review to evaluate prognostic factors that predict successful weaning from V-A ECMO.

methodsFollowing the PRIMSA guidelines, a systematic literature search of Medline, Embase, SCOPUS and CENTRAL identified original research studies of patients requiring V-A ECMO where weaning was attempted. Data was collected on demographic factors and weaning protocol, biomarkers, haemodynamic, echocardiographic factors for the successfully weaned (SW) and not successfully weaned (NSW) groups. Two investigators reviewed studies for relevance, extracted data, and assessed risk of bias using the ROBINS-I tool. The study was registered on the international prospective register of systematic reviews (PROSPERO ID# CRD42022366153).

results1219 records were screened, of which 20 studies were deemed sufficient to be included in the statistical analysis based on pre-specified criteria. Factors associated with successful weaning were higher left ventricular ejection fraction (LVEF) (MD 9.0, 95% CI 4.1-13.8; p < 0.001) and left ventricular outflow tract velocity time integral (LVOT VTI) at time of weaning, (MD 1.35, 95% CI 0.28-2.40 lactate at admission (MD -3.2, 95% CI -4.8 to -1.5, p < 0.001), and CK-MB at admission (MD -4.11, 95%CI -6.6 to -1.6, p = 0.001). Critical appraisal demonstrated moderate-high risk of bias owing to confounding and low sample sizes.

conclusionIn patients on V-A ECMO support being assessed for weaning multi-parametric assessment is required. Moderate-high heterogeneity and low sample sizes warrant higher-quality studies to help guide decisions to wean patients from V-A ECMO.

Indexed as

Extracorporeal Membrane OxygenationHeart FailureHumansPrognosis

Identifiers

PMID40106427
PMCPMC11922212

What OpenQuestion holds

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Registered trials

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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.