Abstract
BACKGROUND: Inconsistent reports exist regarding the efficacy of using a concomitant intra-aortic balloon pump (IABP) among cardiac arrest (CA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR). Thus, this review was conducted to summarize the prognoses of adult ECPR patients with concurrent IABP. METHODS: Data were gathered from PubMed, Embase, MEDLINE, Web of Science, and Cochrane databases. Cohorts of adult patients receiving ECPR with or without IABP, reporting short-term mortality, neurological outcomes, or extracorporeal membrane oxygenation (ECMO) weaning rates, were recruited. Characteristics of the study population and the above-mentioned outcomes were extracted. A random-effects model was used to pool the data. Subgroup analyses were conducted in the propensity score-matching (PSM) population. RESULTS: Nine cohorts with 5260 adult ECPR patients were included. In-hospital/30-day mortality, neurological performances of survivors, and ECMO weaning outcomes were not significantly different between populations with and without IABP. Nevertheless, younger patients with IABP showed an apparent improvement in in-hospital/30-day mortality. Similar findings were demonstrated in the analyses of PSM cohorts. High heterogeneity was present in the total cohort. CONCLUSIONS: In ECPR populations, concomitant IABP did not influence short-term survival, neurological, or ECMO weaning outcomes in the total cohort. However, IABP exhibited a survival benefit in the younger ECPR population. Further research in specific populations is warranted to validate and endorse our aggregated data. THE PROSPERO REGISTRATION: CRD42024528761, Registration Link: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024528761.