• Mohammad Moshiri, Gholamali Dorooshi, Leila Etemad, Awat Feizi, Alireza Rahimi, Farzad Gheshlaghi, Arman Otroshi, Shiva Samsamshariat, and Nastaran Eizadi-Mood.
• Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
• J Res Med Sci. 2024 Jan 1; 29: 6262.

BackgroundAluminum phosphate (ALP) poisoning has a high mortality rate (MR) secondary to cardiogenic shock. Recently, extracorporeal membrane oxygenation (ECMO) showed a successful result in this issue. We conducted a systematic review and meta-analysis to compare the MR of patients with ALP poisoning who underwent ECMO versus those with conventional treatment.Materials And MethodsTwo parallel databases' reviews were done to find the ECMO treatment-applied studies or conventional treatment-applied studies according to the PRISMA protocol. All studies in any languages and English conference abstracts were included for ECMO treatment-applied studies. Only English-language human observational studies, which reported MR, were included in conventional treatment-applied studies. All ETAS case reports were summarized and used as a newly generated cross-sectional study (NGCSS) for inclusion in the meta-analysis.ResultsOut of 167 and 1043 records, 17 case reports (24 cases), 3 cross-sectional studies, and 9 conventional treatment-applied studies were selected. In meta-analysis NGCSS applied as the fourth cross-sectional ECMO treatment-applied studies. The overall MR of ECMO-treated cases (23% [95% confidence interval (CI): 7%-39%]) was significantly less than conventionally treated cases (60% [95% CI: 39%-63%]; P < 0.001). In ECMO-treated cases, the weighted mean difference (WMD) for age, blood pH, ALP dose, hospitalization, ECMO lag time, and ECMO duration were not statistically significant between survived and nonsurvived cases. However, WMD of cardiac ejection fraction (4.6%; 95% CI: 2.76%-6.39%; P < 0.0001), exposure to hospitalization lag time (-2.05; 95% CI: -4.05-0.14 h; P = 0.06), and length of hospital stay (16; 95% CI: 12.0-20.5 days; P < 0.0001) between survived and nonsurvived ETC were significant.ConclusionECMO reduced the MR of ALP-poisoned patients; however, it is a highly invasive and complicated procedure.Copyright: © 2024 Journal of Research in Medical Sciences.

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