Key performance indicators in extracorporeal membrane oxygenation (ECMO): protocol for a systematic review

• Published in: BMJ open 2023-12, Vol.13 (12), p.e076233-e076233
• Main Authors: Tisminetzky, Manuel, Nepomuceno, Roman, Kung, Janice Y, Singh, Gurmeet, Parhar, Ken Kuljit Singh, Bagshaw, Sean M, Fan, Eddy, Rewa, Oleksa
• Format: Article
• Language: English
• Subjects: adult intensive & critical care; Business metrics; Carbon dioxide; Carbon dioxide removal; Cardiac arrest; Coronary vessels; Critical care; Critical Illness - therapy; Extracorporeal Membrane Oxygenation; Hemorrhage; Humans; Intensive Care; Ischemia; Medical prognosis; Mortality; Neonatal care; neonatal intensive & critical care; Newborn babies; paediatric intensive & critical care; Patients; Pediatrics; Respiratory failure; Surgical apparatus & instruments; Systematic review; Systematic Reviews as Topic; Thrombosis; Transplants & implants; Veins & arteries; Ventilators
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-076233

IntroductionExtracorporeal membrane oxygenation (ECMO) is an intervention used in critically ill patients with severe cardiopulmonary failure that is expensive and resource intensive and requires specialised care. There remains a significant practice variation in its application. This systematic review will assess the evidence for key performance indicators (KPIs) in ECMO.Methods and analysisWe will search Ovid MEDLINE, Ovid EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library including the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials and databases from the National Information Center of Health Services Research and Health Care Technology, for studies involving KPIs in ECMO. We will rate methodological quality using the Newcastle-Ottawa Quality Assessment Scale. Randomized controlled trials (RCTs) will be evaluated with the Cochrane Risk of Bias tool, and qualitative studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist). Grey literature sources will be searched for technical reports, practice guidelines and conference proceedings. We will identify relevant organisations, industry leaders and non-profit organisations that represent key opinion leads in the use of ECMO. We will search the Agency of Healthcare Research and Quality National Quality Measures Clearinghouse for ECMO-related KPIs. Studies will be included if they contain quality measures that occur in critically ill patients and are associated with ECMO. The analysis will be primarily descriptive. Each KPI will be evaluated for importance, scientific acceptability, utility and feasibility using the four criteria proposed by the US Strategic Framework Board for a National Quality Measurement and Reporting System. Finally, KPIs will be evaluated for their potential operational characteristics, their potential to be integrated into electronic medical records and their affordability, if applicable.Ethics and disseminationEthical approval is not required as no primary data will be collected. Findings will be published in a peer-reviewed journal and presented at academic.PROSPERO registration number9 August 2022. CRD42022349910.