Appendix A: Methods and literature search strategy

Methods and literature search strategy

NICE has identified studies and reviews relevant to extracorporeal membrane oxygenation (ECMO) for acute heart failure in adults from the medical literature.

Search strategy design and peer review

This search report is informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S).

A NICE information specialist ran the literature searches on 18^th September 2024. See the search strategy history for the full search strategy for each database. Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.

The principal search strategy was developed in MEDLINE ALL (Ovid interface). It was adapted for use in each of the databases listed in table 4a, taking into account the database's size, search functionality and subject coverage. The MEDLINE ALL strategy was quality assured by a NICE senior information specialist. All translated search strategies were peer reviewed to ensure their accuracy. The quality assurance and peer review procedures were adapted from the Peer Review of Electronic Search Strategies (PRESS) 2015 evidence-based checklist.

Review management

The search results were managed in EPPI‑Reviewer version 5 (EPPI‑R5). Duplicates were removed in EPPI‑R5 using a 2‑step process. First, automated deduplication was done using a high-value algorithm. Second, manual deduplication was used to assess low-probability matches. All decisions about inclusion, exclusion and deduplication were recorded and stored.

Limits and restrictions

The CENTRAL database search removed trial registry records and conference material. The Embase search excluded conference material. We excluded the following publication types in MEDLINE: letter or historical article or comment or editorial or news or case reports. We excluded letters and editorial from the Embase search. English language limits were applied to the search when possible in the database.

The search was limited from March 2013 to September 2024. The date limit was included to update searches undertaken for an earlier version of this guidance.

The limit to remove animal studies in the searches is standard NICE practice, which has been adapted from Dickersin K, Scherer R, Lefebvre C (1994) Systematic Reviews: Identifying relevant studies for systematic reviews. BMJ 309(6964): 1286.

Main search

**Table 4a Main search results**
Database	Date searched	Database platform	Database segment or version	Number of results downloaded
Cochrane Central Register of Controlled Trials (CENTRAL)	18/08/24	Wiley	Issue 8 of 12, August 2024	410
Cochrane Database of Systematic Reviews (CDSR)	20/08/24	Wiley	Issue 9 of 12, September 2024	13
Embase	20/08/24	Ovid	1974 to 2024 September 17	2101
INAHTA International HTA Database	18/09/24	https://database.inahta.org/	-	24
MEDLINE ALL	18/09/24	Ovid	1946 to Sept 17, 2024	1454

[MEDLINE ALL] search strategy

1 , Heart Failure/th , 29,868

2 , Acute disease/th , 1,194

3 , 1 and 2 , 11

4 , *Cardiomyopathies/th , 1,150

5 , *Shock cardiogenic/th , 2,135

6 , Myocardial Stunning/th [Therapy] , 155

7 , Myocarditis/th [Therapy] , 1,294

8 , *Myocardial infarction/ , 138,977

9 , Out-of-Hospital Cardiac Arrest/th [Therapy] , 5,734

10 , ((acute* or server*) adj (heart* or cardiac* or myocard* or cardio* or ventric*) adj (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)).ti,ab. , 9,513

11 , Myocardit*.ti,ab. , 21,440

12 , ((Postpartum* or post-parttum* or peripartum* or peri-partum*) adj cardiomyopath*).ti,ab. , 1,697

13 , PPCM.ti,ab. , 671

14 , (myocard* adj (stun* or hibernat* or infract*)).ti,ab. , 2,258

15 , Primary Graft Dysfunction/th [Therapy] , 99

16 , (primary* adj graft* adj dysfunct*).ti,ab. , 1,392

17 , or/3-16 , 182,062

18 , *Cardiopulmonary Resuscitation/mt [Methods] , 4,116

19 , *Extracorporeal Membrane Oxygenation/ , 13,895

20 , ECMO.ti. , 3,217

21 , *Extracorporeal Circulation/mt [Methods] , 1,090

22 , (extracorp* adj circulat*).ti,ab. , 8,596

23 , (extracorp* adj ((cardiopulmon* adj resuscitat*) or CPR)).ti,ab. , 1,229

24 , ECPR.ti. , 154

25 , (Biomedicus adj pump*).ti,ab. , 45

26 , (Maquet* adj rotaflow*).ti,ab. , 12

27 , (jostra adj (pump* or rotaflow*)).ti,ab. , 5

28 , (levitronix adj (centrimag* or pump* or system* or oxygen*)).ti,ab. , 54

29 , (Medos adj (Hilite* or oxygen*)).ti,ab. , 22

30 , left ventricle assist device.ti,ab. , 106

31 , or/18-30 , 28,477

32 , 17 and 31 , 2,725

33 , animals/ not human/ , 5,225,551

34 , 32 not 33 , 2,680

35 , limit 34 to english language , 2,503

36 , limit 35 to ed=20130331-20240930 , 2,028

37 , limit 36 to (letter or historical article or comment or editorial or news or case reports) , 574

38 , 36 not 37 , 1,454

[Embase] search strategy

1 , heart failure/th [Therapy] , 15,752

2 , acute disease/th [Therapy] , 2,395

3 , 1 and 2 , 10

4 , *cardiomyopathy/th [Therapy] , 1,144

5 , *cardiogenic shock/th [Therapy] , 2,129

6 , stunned heart muscle/th [Therapy] , 53

7 , myocarditis/th [Therapy] , 864

8 , *heart infarction/ , 110,365

9 , primary graft dysfunction/th [Therapy] , 94

10 , "out of hospital cardiac arrest"/th [Therapy] , 3,862

11 , ((acute* or server*) adj (heart* or cardiac* or myocard* or cardio* or ventric*) adj (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)).ti,ab. , 17,537

12 , Myocardit*.ti,ab. , 31,093

13 , ((Postpartum* or post-parttum* or peripartum* or peri-partum*) adj cardiomyopath*).ti,ab. , 2,835

14 , PPCM.tw. , 1,261

15 , (myocard* adj (stun* or hibernat* or infract*)).ti,ab. , 3,555

16 , (primary* adj graft* adj dysfunct*).tw. , 3,009

17 , or/3-16 , 173,201

18 , *resuscitation/ , 60,473

19 , *extracorporeal oxygenation/ , 16,545

20 , ECMO.ti. , 7,837

21 , *extracorporeal circulation/ , 9,094

22 , (extracorp* adj circulat*).ti,ab. , 9,683

23 , (extracorp* adj ((cardiopulmon* adj resuscitat*) or CPR)).ti,ab. , 1,851

24 , ECPR.ti. , 352

25 , (Biomedicus adj pump*).ti,ab. , 50

26 , (Maquet* adj rotaflow*).ti,ab. , 31

27 , (jostra adj (pump* or rotaflow*)).ti,ab. , 16

28 , (levitronix adj (centrimag* or pump* or system* or oxygen*)).ti,ab. , 150

29 , (Medos adj (Hilite* or oxygen*)).ti,ab. , 44

30 , left ventricle assist device.ti,ab. , 217

31 , or/18-30 , 96,434

32 , 17 and 31 , 5,350

33 , Nonhuman/ not Human/ , 5,532,522

34 , 32 not 33 , 5,275

35 , limit 34 to letter/ or (letter or editorial).pt. , 2,165,352

36 , 34 not 35 , 4,904

37 , limit 36 to dc=20130331-20240930 , 3,599

38 , limit 37 to english language , 3,481

39 , (conference abstract* or conference review or conference paper or conference proceeding).db,pt,su. , 6,020,541

40 , 38 not 39 , 2,101

Cochrane Library (CDSR) search strategy

#1 MeSH descriptor: [Heart Failure] explode all trees and with qualifier(s): [therapy - TH] 2591

#2 MeSH descriptor: [Acute Disease] explode all trees and with qualifier(s): [therapy - TH] 118

#3 #1 and #2 0

#4 MeSH descriptor: [Cardiomyopathies] explode all trees and with qualifier(s): [therapy - TH] 248

#5 MeSH descriptor: [Shock, Cardiogenic] explode all trees and with qualifier(s): [therapy - TH] 177

#6 MeSH descriptor: [Myocardial Stunning] explode all trees and with qualifier(s): [therapy - TH] 3

#7 MeSH descriptor: [Myocarditis] explode all trees and with qualifier(s): [therapy - TH] 13

#8 MeSH descriptor: [Myocardial Infarction] explode all trees and with qualifier(s): [therapy - TH] 3337

#9 MeSH descriptor: [Primary Graft Dysfunction] explode all trees and with qualifier(s): [therapy - TH] 3

#10 MeSH descriptor: [Out-of-Hospital Cardiac Arrest] explode all trees and with qualifier(s): [therapy - TH] 539

#11 ((acute* or server*) near/1 (heart* or cardiac* or myocard* or cardio* or ventric*) near/1 (failur* or decompensation* or insufficient* or dysfunct* or stand* or still* or fault* or shock*)) 2663

#12 Myocardit* 1421

#13 (Postpartum* or post-partum* or peripartum* or peri-partum*) near/1 cardiomyopath* 47

#14 PPCM 39

#15 (myocard* near/1 (stun* or hibernat* or infract*)) 342

#16 (primary* near/1 graft* near dysfunct*) 146

#17 #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 8646

#18 MeSH descriptor: [Cardiopulmonary Resuscitation] this term only 1688

#19 MeSH descriptor: [Extracorporeal Membrane Oxygenation] this term only 361

#20 ECMO 1101

#21 MeSH descriptor: [Extracorporeal Circulation] this term only and with qualifier(s): [methods - MT] 120

#22 (extracorp* near/1 circulat*) 1423

#23 (extracorp* near/1 ((cardiopulmon* near resuscitat*) or CPR)) 71

#24 ECPR 112

#25 (Biomedicus near/1 pump*) 3

#26 (Maquet* rotaflow*) 3

#27 jostra near/1 (pump* or rotaflow*) 1

#28 (levitronix near/1 (centrimag* or pump* or system* or oxygen*)) 0

#29 Medos near/1 (Hilite* or oxygen*) 0

#30 left ventricle assist device 219

#31 #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 4577

#32 #17 AND #31 494

#33 "conference":pt or (clinicaltrials or trialsearch):so 777352

#34 #32 NOT #33 with Cochrane Library publication date Between Mar 2013 and Sep 2024, in Cochrane Reviews 13

[Cochrane Library CENTRAL)] search strategy