Table 2 Summary of findings table
Research topic: Direct thrombin inhibitors compared with heparin for extracorporeal membrane oxygenation therapy | ||||||
|---|---|---|---|---|---|---|
Patients: Adult and pediatric patients Setting: In-hospital extracorporeal membrane oxygenation therapy Intervention: Direct thrombin inhibitors Comparison: Unfractionated heparin | ||||||
Outcomes | Illustrative comparative risksb (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed riska | Corresponding risk | |||||
unfractionated heparin | Direct thrombin inhibitors | |||||
Mortality | 474 per 1000 | 393 per 1000 (346 to 450) | RR 0.83 (0.73 to 0.95) | 1777 (17) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, publication bias | |
Major bleeding events | 501 per 1000 | 336 per 1000 (251 to 456) | RR 0.67 (0.5 to 0.91) | 1355 (16) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, publication bias | |
Minor bleeding events | 287 per 1000 | 247 per 1000 (195 to 316) | RR 0.86 (0.68 to 1.10) | 632 (8) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, imprecision | |
Pump-related thrombosis | 233 per 1000 | 163 per 1000 (121 to 217) | RR 0.7 (0.52 to 0.93) | 1361 (13) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, imprecision, publication bias | |
Patient-related thrombosis | 200 per 1000 | 162 per 1000 (118 to 220) | RR 0.81 (0.59 to 1.10) | 1447 (15) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, inconsistency, publication bias | |
length of ECMO therapy (hours and days) | See comment | The SMD in length of ECMO therapy in the intervention groups was 0.12 higher (-0.03 lower to 0.27 higher) | 1274 (12) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, imprecision, publication bias | Mean for control group not estimable as different measures were used for outcome assessment | |
length of hospital stay (days) | The mean time to anticoagulation goal ranged across control groups from 5 to 47 days | The SMD in length of hospital stay in the intervention groups was 0.19 higher (-0.30 lower to 0.69 higher) | 467 (4) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, imprecision, publication bias | ||
time to anticoagulation goal (hours) | The mean time to anticoagulation goal ranged across control groups from 9 to 32 h | The SMD in time to anticoagulation goal in the intervention groups was 0.2 lower (-0.73 lower to 0.34 higher) | 324 (4) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, imprecision, publication bias | ||
Percentage of time within therapeutic range (percentage) | The mean percentage of time within therapeutic range ranged across control groups from 11 to 31 percent | The SMD of percentage of time within therapeutic range in the intervention groups was 0.54 higher (0.14 to 0.94 higher) | 491 (5) | ⊕ ⊝ ⊝ ⊝ very low due to lack of RCTs, risk of bias, publication bias | ||