Table 1.
Baseline characteristics of included studies
| Combes et al. [1], 2018 | Guervilly et al. [9], 2019 | COVID-ICU [29], 2020 | Garcia et al. [25], 2020 | Jozwiak et al. [28], 2020 | Le Breton et al. [30], 2020 | Rilinger et al. [26], 2020 | |
|---|---|---|---|---|---|---|---|
| Study type | RCTb | Observational | Observational | Observational | Observational | Observational | Observational |
| Country | France, USA, Australia, Canada | France | France, Belgium, Switzerland | France | France | France | Germany |
| N participating ICUs | 42 | 1 | 138 | 1 | 1 | 1 | 1 |
| N | |||||||
| Overall | 124 | 168 | 269 | 25 | 11 | 13 | 158 |
| PP during ECMO | 17 | 91 | 184 | 14 | 6 | 7 | 38 |
| Pneumonia as main cause of ARDS, N (%) | 80 (65) | NA | 269 (100) | 25 (100) | 11 (100) | 13 (100) | 116 (73) |
| Only COVID patients | No | No | Yes | Yes | Yes | Yes | No |
| Mean (SD) or median (IQR) duration of invasive mechanical ventilation before ECMO initiation | 1.4 (0.6–3.7) | 5 (6) | NA | 7 (4–10) | 6 (3–11) | 6 (3.5–6.5) | 1.3 (0.3–5) |
| Mean age (SD), years | |||||||
| ECMO only | NA | 53 (13) | NA | 57 (48–66) | NA | 52 (9) | 52 (39–64) |
| ECMO + PP | 49 (15) | 59 (48–63) | 47 (6) | 56 (44–64) | |||
| Male gender, N (%) | |||||||
| ECMO only | NA | 52 (67) | NA | 10 (91) | NA | 5 (83) | 78 (65) |
| ECMO + PP | 66 (72) | 12 (86) | 5 (71) | 28 (74) | |||
| Mean (SD) SOFA score at cannulation | |||||||
| ECMO only | NA | 11 (4) | NA | NA | NA | 11 (2) | 14 (11–17) |
| ECMO + PP | 10 (4) | 9 (2) | 13 (11–15) | ||||
| Indication for PP | Not specified | specified | Not specified | specified | Not specified | Not specified | Not specified |
| Mean (SD) or median (IQR) days of ECMO before PP | NA | 5 (4) | NA | 1.5 (1–3) | NA | NA | 1.7 (0.5–5) |
| Duration of PP | NA | 12 to 16 h | NA | 16 (15–17) h | NA | NA | 20 (17–21) h |
| Mechanical ventilation protocol | specified | specified | Not specified | specified | Not specified | Not specified | specified |
| Patients who received PP prior ECMO, N (%) | |||||||
| ECMO only | NA | 39 (50) | NA | 11 (100) | 5 (100) | NA | 19 (16) |
| ECMO + PP | 69 (76) | 14 (100) | 6 (100) | 7 (18) | |||
| Mean (SD) or median (IQR) PaO2/FiO2 under ECMO before PP | NA | 135 (57) | NA | 84 (73–108) | NA | NA | 77 (63–107) |
| Corticosteroids on ECMO, N (%) | 80 (65) | NA | NA | 4 (16) | NA | NA | NA |
| Primary outcome | 60-day mortality | 90-day survival | 90-day mortality | 28-day mortality | ICU mortality | ICU mortality | Hospital survival |
| Schmidt et al. [31], 2020 | Chaplin et al. [24], 2021 | Giani et al. [8], 2021 | Lebreton et al. [32], 2021 | Petit et al. [10], 2021 | Yang et al. [27], 2021 | |
|---|---|---|---|---|---|---|
| Study type | Observational | Observational | Observational | Observational | Observational | Observational |
| Country | France | New Zealand | Italy | France | France | China |
| N participating ICUs | 5 | 1 | 6 | 17 | 1 | 21 |
| N | ||||||
| Overall | 83 | 72 | 240 | 302 | 298 | 73 |
| PP during ECMO | 67 | 13 | 107 | 193 | 64 | 51 |
| Pneumonia as main cause of ARDS, N (%) | 83 (100) | 62 (86) | 221 (92) | 302 (100) | 222 (74) | 73 (100) |
| Only COVID patients | Yes | No | No | Yes | No | Yes |
| Mean (SD) or median (IQR) duration of invasive mechanical ventilation before ECMO initiation | 4 (3–6) | NA | 2 (1–6) | 5 (3–7) | 4 (1–10) |
4 (1-7) [n = 59] 1.5 (0–6) [n = 14] |
| Mean (SD) or median (IQR) age, years | ||||||
| ECMO only | NA | 46 (34–56) | 49 (13) | NA | 51 (39–60) | NA |
| ECMO + PP | 45 (36–48) | 48 (13) | NA | 53 (45–61) | ||
| Male gender, N (%) | ||||||
| ECMO only | NA | 39 (66) | 83 (62) | NA | 160 (68) | NA |
| ECMO + PP | 7 (54) | 73 (68) | NA | 43 (67) | ||
| Mean (SD) or median (IQR) SOFA score at cannulation | ||||||
| ECMO only | NA | NA | 10 (4) | NA | 14 (10–17) | NA |
| ECMO + PP | 9 (3) | NA | 13 (9–16) | |||
| Indication for PP | Not specified | Not specified | Not specified | Not specified | Specified | Not specified |
| Mean (SD) or median (IQR) days of ECMO before PP | NA | 8 (5–17.5) | 4 (2–7) | NA | 3 (2–6) | NA |
| Duration of PP | NA | 11 (7–16) | 15 (12–18) ha | NA | 16 h | NA |
| Mechanical ventilation protocol | Specified | Not specified | Specified | Specified | Specified | Not specified |
| Patients who received PP prior ECMO, N (%) | ||||||
| ECMO only | NA | NA | 38 (35) | NA | 141 (60) | NA |
| ECMO + PP | 34 (32) | NA | 55 (86) | |||
| Mean (SD) or median (IQR) PaO2/FiO2 under ECMO before PP | NA | 145 (127–158) | 135 (61) | NA | NA | NA |
| Corticosteroids on ECMO, N (%) | 17 (20) | NA | NA | 84 (28) | NA | 45 (62) |
| Primary outcome | 60-day survival | 6-month survival | Hospital mortality | 90-day survival | 90-day mortality | Hospital mortality |
aMedian (IQR)
bRCT, randomized controlled trial comparing ECMO and controls with ECMO as a late rescue strategy