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A systematic review of effectiveness and economic evaluation of Cardiohelp and portable devices for extracorporeal membrane oxygenation (ECMO)

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  • Artificial Lung / ECMO
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Abstract

In recent years, there have been substantial advancements in the development of different technologies for extracorporeal membrane oxygenation (ECMO) for in-hospital and out of hospital applications. However the effectiveness of these devices is not clearly known. The objective of this study was to evaluate the cost-effectiveness of Cardiohelp compared to other portable ECMO devices. In this systematic review, we searched Medline (via Ovid), Embase, Pubmed, Cochrane Library, SCOPUS, CRD and NICE. Articles were assessed by two independent reviewers for eligibility and quality of the evidence. Studies which compared Cardiohelp to other ECMO devices were included. Seven out of 1316 publication were included in this review, three of them were clinical trials and four were observational studies. The majority of the studies had limited quality. According to the measures of safety, Cardiohelp had safer technological features, but on the other hand, was more complex to use. Considering the effectiveness, Cardiohelp was not statistically different from other technologies. Cardiohelp showed slightly better performance than Centrimag in terms of cost per patient and cost-effectiveness. However, when clinical criteria were used to select the patients with good prognosis to administer the ECMO, incremental cost utility ratios (ICURs) for both Cardiohelp and Centrimag were below the level of willingness-to-pay threshold. According to the measures of safety and effectiveness, ECMO with Cardiohelp was not considerably different from other evaluated technologies. Moreover, ECMO with Cardiohelp or Centrimag can be considered cost-effective, provided that the patients are selected carefully in terms of neurological outcomes.

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Acknowledgements

This work was funded by the National Institute for Health Research (NIHR) of Iran. The funder is not involved in the design of the study or collection, analysis and interpretation of data, or in writing the manuscript. The views expressed are those of the authors and not necessarily those of the NIHR.

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Authors and Affiliations

  1. Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

    Alireza Mahboub-Ahari

  2. National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Mahboub-Ahari

  3. Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Fariba Heidari

  4. Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Fatemeh Sadeghi-Ghyassi & Maryam Asadi

  5. School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

    Fatemeh Sadeghi-Ghyassi

Authors
  1. Alireza Mahboub-Ahari
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  2. Fariba Heidari
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  3. Fatemeh Sadeghi-Ghyassi
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  4. Maryam Asadi
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Correspondence to Fariba Heidari.

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Mahboub-Ahari, A., Heidari, F., Sadeghi-Ghyassi, F. et al. A systematic review of effectiveness and economic evaluation of Cardiohelp and portable devices for extracorporeal membrane oxygenation (ECMO). J Artif Organs 22, 6–13 (2019). https://doi.org/10.1007/s10047-018-1067-9

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  • DOI: https://doi.org/10.1007/s10047-018-1067-9

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