PMID- 34903457
OWN - NLM
STAT- MEDLINE
DCOM- 20220615
LR  - 20220801
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 36
IP  - 8 Pt A
DP  - 2022 Aug
TI  - Effect of Body Mass Index on the Clinical Outcomes of Adult Patients Treated With 
      Venoarterial ECMO for Cardiogenic Shock.
PG  - 2376-2384
LID - S1053-0770(21)00978-2 [pii]
LID - 10.1053/j.jvca.2021.11.012 [doi]
AB  - OBJECTIVE: Current guidelines consider obesity to be a relative contraindication 
      to venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory 
      cardiogenic shock. The authors investigated the effect of body mass index (BMI) 
      on clinical outcomes in patients treated with VA-ECMO for cardiogenic shock. 
      DESIGN: This was a retrospective and observational study. SETTING: University 
      hospital. PARTICIPANTS: The study comprised 150 adult patients who underwent 
      VA-ECMO for cardiogenic shock. MEASUREMENTS AND MAIN RESULTS: The primary outcome 
      was intensive care unit (ICU) mortality. Of the 150 included patients, 10 were 
      underweight (BMI < 18.5 kg/m(2)), 62 were normal weight (BMI = 18.5-24.9 kg/m(2)), 34 
      were overweight (BMI = 25.0-29.9 kg/m(2)), 34 were obese class I (BMI = 30.0-34.9 
      kg/m(2)), and 10 were obese class II (BMI = 35.0-39.9 kg/m(2)). All-cause ICU 
      mortality was 62% (underweight, 70%; normal weight, 53%; overweight, 65%; class I 
      obese, 71%; class II obese, 70%). After multivariate logistic regression, BMI was 
      not associated with ICU mortality (adjusted odds ratio [aOR] 0.99 [0.92-1.07], 
      p = 0.8). Analysis by BMI category showed unfavorable mortality trends in 
      underweight patients (aOR 3.58 [0.82-19.6], p = 0.11) and class I obese patients 
      (aOR 2.39 [0.95-6.38], p = 0.07). No statistically significant differences were 
      found among BMI categories in the incidences of complications. CONCLUSION: The 
      results suggested that BMI alone should not be considered an exclusion criterion 
      for VA-ECMO. The unfavorable trend observed in underweight patients could be the 
      result of malnutrition.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Girard, Leandre
AU  - Girard L
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France. Electronic address: 
      leandre.girard.ar@gmail.com.
FAU - Djemili, Fares
AU  - Djemili F
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Devineau, Marjolaine
AU  - Devineau M
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Gonzalez, Celine
AU  - Gonzalez C
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Puech, Berenice
AU  - Puech B
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Valance, Dorothee
AU  - Valance D
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Renou, Amelie
AU  - Renou A
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Dubois, Gilbert
AU  - Dubois G
AD  - Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier 
      Universitaire de La Reunion Site Felix Guyon, Saint-Denis, France.
FAU - Braunberger, Eric
AU  - Braunberger E
AD  - Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier 
      Universitaire de La Reunion Site Felix Guyon, Saint-Denis, France.
FAU - Allou, Nicolas
AU  - Allou N
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Allyn, Jerome
AU  - Allyn J
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Vidal, Charles
AU  - Vidal C
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20211112
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
MH  - Adult
MH  - Body Mass Index
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Humans
MH  - Obesity/complications/epidemiology
MH  - Overweight/complications
MH  - Retrospective Studies
MH  - *Shock, Cardiogenic/etiology
MH  - Thinness/complications/epidemiology
OTO - NOTNLM
OT  - ECMO
OT  - body mass index
OT  - cardiogenic shock, mortality
OT  - malnutrition
OT  - obesity, underweight
OT  - venoarterial extracorporeal membrane oxygenation
EDAT- 2021/12/15 06:00
MHDA- 2022/06/16 06:00
CRDT- 2021/12/14 06:15
PHST- 2021/08/19 00:00 [received]
PHST- 2021/10/21 00:00 [revised]
PHST- 2021/11/07 00:00 [accepted]
PHST- 2021/12/15 06:00 [pubmed]
PHST- 2022/06/16 06:00 [medline]
PHST- 2021/12/14 06:15 [entrez]
AID - S1053-0770(21)00978-2 [pii]
AID - 10.1053/j.jvca.2021.11.012 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt A):2376-2384. doi: 
      10.1053/j.jvca.2021.11.012. Epub 2021 Nov 12.