Low GWRs which were obtained from brain CT scans in comatose CA patients after restoration of spontaneous circulation were associated with poor neurological outcomes. GWR from brain CT can be a useful parameter for prognostic prediction aiding to an optimal clinical decision process in comatose CA survivors.

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BACKGROUND:This meta-analysis aimed to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients with cardiac arrest (CA).DATA RESOURCES: PubMed, EMBASE, Web of Science, and China Biological Medicine Database were searched for relevant articles. The baseline information and outcome data (survival, good neurological outcome at discharge, at 3-6 months, and at 1 year after CA) were collected and extracted by two authors. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using Review Manager 5.3. RESULTS:In six studies 2 260 patients were enrolled to study the survival rate to discharge and longterm neurological outcome published since 2000. A signifi cant effect of ECPR was observed on survival rate to discharge compared to CCPR in CA patients (RR 2.37, 95%CI 1.63-3.45, P<0.001), and patients who underwent ECPR had a better long-term neurological outcome than those who received CCPR (RR 2.79, 95%CI 1.96-3.97, P<0.001). In subgroup analysis, there was a significant difference in survival to discharge favoring ECPR over CCPR group in OHCA patients (RR 2.69, P=0.001). However, no signifi cant difference was found in IHCA patients (RR 1.84, 95%CI 0.91-3.73, P=0.09).CONCLUSION: ECPR showed a benefi cial effect on survival rate to discharge and long-term neurological outcome over CCPR in adult patients with CA.