Objective: The effect of body habitus for patients who require extracorporeal membrane oxygenation (ECMO) support has not been well-studied and may provide insight into patient survival and outcomes. We sought to determine if there is a correlation of body mass index (BMI) with ECMO outcomes.
Methods: A retrospective chart review was performed for patients who required any form of ECMO support at our institution between 2012 and 2016. Time variables (overall hospital length of stay, intensive care, and ventilator days), and outcomes variables (ability to wean from ECMO, extubation status, hospital survival, 30-day survival) were studied. Patients were divided into cohorts based on BMI. Descriptive statistics were used to summarize data. Spearman correlation, Fisher's exact test, and independent t-test were used to assess associations.
Results: A total of 231 patients required ECMO with a mean BMI of 29 (±6.47; BMI range, 17.6-57.9). The mean BMI did not differ based on type of support provided (veno-veno ECMO [VV] vs veno-arterial [VA]). There was no difference between BMI cohorts for length of stay, time in the intensive care unit (ICU), ability to wean from ECMO, hospital survival or 30-day survival. Raw BMI did not predict if or when patients were extubated.
Conclusions: Neither obesity classification nor BMI as a continuous variable affected any of the outcome variables. Respiratory outcomes including the ability to extubate and to remain ventilator-free were also independent of patient BMI. These data suggest that extremes of body habitus alone should not be used as an exclusion criteria for consideration of ECMO support.
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http://dx.doi.org/10.1111/jocs.14579 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: Carinal resection and reconstruction are complex surgical procedures often necessitated by tumors or other pathologies involving the tracheobronchial junction. Traditional approaches to these surgeries are highly invasive. The advent of uniportal video-assisted thoracoscopic surgery (VATS) along with the integration of extracorporeal membrane oxygenation (ECMO) offer potential advantages in reducing surgical trauma and improving outcomes.
View Article and Find Full Text PDFCan J Cardiol
December 2024
Senior Consultant Intensive Care, Royal Childrens Hospital, Melbourne, Australia; Professor Department of Critical Care, Faculty of Medicine, Melbourne University.
Whilst Extra-Corporeal Membrane Oxygenation (ECMO) for circulatory support in patients with severe septic shock, commenced in newborn infants and children in the late 1980's, ECMO has remained a controversial treatment for adults with refractory septic shock (RSS). This is fundamentally due to differences in the predominant hemodynamic response to sepsis. In newborn infants and very young children ventricular failure called Low Cardiac Output Syndrome (LCOS) is the major hemodynamic response whilst adolescents and adults have mainly vasoplegic shock.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
Cardiogenic shock (CS) in acute myocardial infarction (AMI) is a life-threatening syndrome characterized by systemic hypoperfusion that can quickly progress to multiorgan failure and death. Various devices and configurations of mechanical circulatory support (MCS) exist to support patients, each with unique pathophysiological characteristics. The Intra-aortic balloon pump can improve coronary perfusion, decrease afterload, and indirectly augment cardiac output.
View Article and Find Full Text PDFRev Cardiovasc Med
December 2024
Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
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