Predictors associated with successful weaning of veno-venous extracorporeal membrane oxygenation and mortality in adult patients with severe acute lung failure: Protocol of a pooled data analysis of cohort studies

Yaxin Ning; Linya He; Keqi Pan; Weiwen Zhang; Jian Luo; Yan Chen; Zubing Mei; Danqiong Wang

doi:10.1371/journal.pone.0303282

Predictors associated with successful weaning of veno-venous extracorporeal membrane oxygenation and mortality in adult patients with severe acute lung failure: Protocol of a pooled data analysis of cohort studies

PLoS One. 2024 May 17;19(5):e0303282. doi: 10.1371/journal.pone.0303282. eCollection 2024.

Authors

Yaxin Ning¹, Linya He¹, Keqi Pan², Weiwen Zhang³, Jian Luo³, Yan Chen¹, Zubing Mei^{4

5}, Danqiong Wang²

Affiliations

¹ The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
² School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China.
³ Department of Critical Care Medicine, Quzhou People's Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China.
⁴ Department of Anorectal Surgery, Anorectal Disease Institute of Shuguang Hospital, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
⁵ Anorectal Disease Institute of Shuguang Hospital, Shanghai, China.

Abstract

Background: Severe acute lung failure (ALF) often necessitates veno-venous extracorporeal membrane oxygenation (VV-ECMO), where identifying predictors of weaning success and mortality remains crucial yet challenging. The study aims to identify predictors of weaning success and mortality in adults undergoing VV-ECMO for severe ALF, a gap in current clinical knowledge.

Methods and analysis: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials will be searched for cohort studies examining the predictive factors of successful weaning and mortality in adult patients on VV-ECMO due to severe ALF. Risk of bias assessment will be conducted using the Newcastle-Ottawa scale for each included study. The primary outcomes will be successful weaning from VV-ECMO and all-cause mortality. Between-study heterogeneity will be evaluated using the I2 statistic. Sensitivity, subgroup, and meta-regression analyses will be performed to ascertain potential sources of heterogeneity and assess the robustness of our results. We will use the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool to recommend the level of evidence.

Discussion: This study seeks to provide clinically significant insights into predictors for weaning and mortality during VV-ECMO treatment for ALF, aiming to support clinical decisions and potentially influence health policy, thereby improving patient outcomes.

Ethics and dissemination: Given the absence of direct engagement with human subjects or access to personal medical records, ethical approval for this study is deemed unnecessary. The study findings will be shared at a scientific conference either at the global or national level. Alternatively, the results will be presented for publication in a rigorously peer-reviewed journal regarding critical care medicine.

Copyright: © 2024 Ning et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Acute Lung Injury* / mortality
Acute Lung Injury* / therapy
Adult
Cohort Studies
Extracorporeal Membrane Oxygenation* / methods
Humans

Grants and funding

This work was supported by Medical and Health Science and Technology Project of Zhejiang Province (grant no. 2023KY1295), High Level Talents Project of Zhejiang (grant no. 2020-167) and Science and Technology Project of Quzhou (2023K118). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.