الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
This meta-analysis presents statistically significant association between nutrition support and clinical outcomes for adult critically-ill patients receiving ECMO therapy.
RECOMMENDATIONS
Based on the results of the current meta-analysis, we recommend early and adequate nutrition support for ICU patients receiving ECMO therapy.
SUMMARY
Extracorporeal Membrane Oxygenation (ECMO) is an advanced lifesaving therapy administrated to critically-ill patients with respiratory, cardiac or combined failure who are refractory to conventional treatment.
The VA type is administrated for cardiac and pulmonary support, whereas the VV type is used for reversible respiratory failure with normal cardiac function.
Patients receiving ECMO therapy require vital organ support as they cannot meet nutritional needs orally for a long period leading to catabolic state, negative nitrogen balance and insulin resistance.
Adequate nutritional support may be hard to achieve and represents a real challenge due to hemodynamic instability and the need for large doses of vasopressors, steroids and deep sedation, that leads to delayed gastric emptying and mesenteric ischaemia.
In critically-ill patients, malnutrition is associated with high morbidity and mortality, and may lead to delayed recovery, increased length of stay in the ICU and incidence of infection, conversely, adequate nutrition therapy could lead to positive outcomes.
The aim of the meta-analysis was to evaluate the effect of nutritional intervention on clinical outcomes for adult critically-ill patients receiving ECMO therapy. The 28-days mortality was the primary outcome and incidence of infection, length of ICU stay and days of mechanical ventilation were the secondary outcomes.
By advanced literature search, seven studies from different countries, with a total number of 2358 provided data for the meta-analysis. We analyzed 7 studies from 2013 to 2020 with sample size ranging from 41 to 1679. All of the patients were critically-ill, admitted to ICU and receiving ECMO for any indication.
The 7 included studies were combined and their estimated were pooled for analysis. Pooling of the results provides more evidence than do results from individual studies.
Meta-analysis results indicate statistically significant association between nutrition support and clinical outcomes. And based on the results, we recommend early and adequate nutrition support for adult critically-ill patients receiving ECMO therapy.