What we have learned about minimized extracorporeal circulation versus conventional extracorporeal circulation: an updated meta-analysis

Int J Artif Organs. 2015 Aug;38(8):444-53. doi: 10.5301/ijao.5000427. Epub 2015 Aug 28.

Abstract

Introduction: The benefits of minimized extracorporeal circulation (MECC) compared with conventional extracorporeal circulation (CECC) are still in debate.

Methods: PubMed, EMBASE and the Cochrane Library were searched until November 10, 2014. After quality assessment, we chose a fixed-effects model when the trials showed low heterogeneity, otherwise a random-effects model was used. We performed univariate meta-regression and sensitivity analysis to search for the potential sources of heterogeneity. Cumulative meta-analysis was performed to access the evolution of outcome over time.

Results: 41 RCTs enrolling 3744 patients were included after independent article review by 2 authors. MECC significantly reduced atrial fibrillation (RR, 0.76; 95% CI, 0.66 to 0.89; P < 0.001; I2 = 0%), and myocardial infarction (RR, 0.43; 95% CI, 0.26 to 0.71; P = 0.001; I2 = 0%). In addition, the results regarding chest tube drainage, transfusion rate, blood loss, red blood cell transfusion volume, and platelet count favored MECC as well.

Conclusions: MECC diminished morbidity of cardiovascular complications postoperatively, conserved blood cells, and reduced allogeneic blood transfusion.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atrial Fibrillation / prevention & control
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion / statistics & numerical data
  • Cardiac Surgical Procedures
  • Chest Tubes / statistics & numerical data
  • Extracorporeal Circulation / methods*
  • Humans
  • Postoperative Complications