BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (ECMO) has increased as a bridge to recovery for acute respiratory distress syndrome (ARDS) refractory to conventional support. Morbid obesity can pose a significant challenge to obtaining indexed flows, and outcomes in this population are not well described. METHODS: Patients requiring ECMO for ARDS between January 2009 and November 2012 were retrospectively reviewed. Demographics, ECMO variables, and outcomes were assessed. Morbid obesity and super obesity were defined as a body mass index (BMI) greater than 40 kg/m(2) and greater than 50 kg/m(2), respectively. RESULTS: Fifty-five patients with ARDS were placed on ECMO during the study period. Twelve were morbidly obese with a BMI of 49.0 kg/m(2) (interquartile range [IQR]: 45.4-57.3 kg/m(2)). Pre-ECMO mechanical ventilatory support and indices of disease severity were similar between the 2 groups, as were cannulation strategy and duration of ECMO support. Nine (75%) morbidly obese patients and 27 (63%) non-morbidly obese patients were successfully weaned from ECMO support, and patient survival to time of discharge was 67% and 58%, respectively. In the subset of super obese patients (n = 6; BMI, 57.3 kg/m(2) [IQR: 51.3-66.5 kg/m(2)]), recovery and midterm survival was 100%. CONCLUSIONS: In this review, class III obesity was not associated with poorer outcomes, and based on these data, ECMO support should not be withheld from this patient population.
BACKGROUND: The use of venovenous extracorporeal membrane oxygenation (ECMO) has increased as a bridge to recovery for acute respiratory distress syndrome (ARDS) refractory to conventional support. Morbid obesity can pose a significant challenge to obtaining indexed flows, and outcomes in this population are not well described. METHODS:Patients requiring ECMO for ARDS between January 2009 and November 2012 were retrospectively reviewed. Demographics, ECMO variables, and outcomes were assessed. Morbid obesity and super obesity were defined as a body mass index (BMI) greater than 40 kg/m(2) and greater than 50 kg/m(2), respectively. RESULTS: Fifty-five patients with ARDS were placed on ECMO during the study period. Twelve were morbidly obese with a BMI of 49.0 kg/m(2) (interquartile range [IQR]: 45.4-57.3 kg/m(2)). Pre-ECMO mechanical ventilatory support and indices of disease severity were similar between the 2 groups, as were cannulation strategy and duration of ECMO support. Nine (75%) morbidly obesepatients and 27 (63%) non-morbidly obesepatients were successfully weaned from ECMO support, and patient survival to time of discharge was 67% and 58%, respectively. In the subset of super obesepatients (n = 6; BMI, 57.3 kg/m(2) [IQR: 51.3-66.5 kg/m(2)]), recovery and midterm survival was 100%. CONCLUSIONS: In this review, class III obesity was not associated with poorer outcomes, and based on these data, ECMO support should not be withheld from this patient population.
Authors: Melissa M Felinski; Daniyal Abbas; Peter A Walker; John A Primomo; Tanyaradzwa M Kajese; Biswajit Kar; Igor D Gregoric; Igor Banjac; Lisa Janowiak; Sriram Nathan; Rahat Hussain; Sheilendra S Mehta; Kulvinder S Bajwa; Shinil K Shah; Bindu Akkanti Journal: J Extra Corpor Technol Date: 2021-09
Authors: Samuel Heuts; Maged Makhoul; Abdulrahman N Mansouri; Fabio Silvio Taccone; Amir Obeid; Mirko Belliato; Lars Mikael Broman; Maximilian Malfertheiner; Paolo Meani; Giuseppe Maria Raffa; Thijs Delnoij; Jos Maessen; Gil Bolotin; Roberto Lorusso Journal: Artif Organs Date: 2021-09-07 Impact factor: 2.663
Authors: Francesco Zadek; Jonah Rubin; Luigi Grassi; Daniel Van Den Kroonenberg; Grant Larson; Martin Capriles; Roberta De Santis Santiago; Gaetano Florio; David A Imber; Edward A Bittner; Kathryn A Hibbert; Alex Legassey; Jeliene LaRocque; Gaston Cudemus-Deseda; Aranya Bagchi; Jerome Crowley; Kenneth Shelton; Robert Kacmarek; Lorenzo Berra Journal: Crit Care Explor Date: 2021-06-29
Authors: Mazen Odish; Cassia Yi; Christopher Tainter; Samira Najmaii; Julio Ovando; Laura Chechel; Jerry Lipinski; Alex Ignatyev; Alexander Pile; Yun Yeong Jang; Tuo Lin; Xin M Tu; Michael Madani; Mitul Patel; Angela Meier; Travis Pollema; Robert L Owens Journal: Crit Care Explor Date: 2021-06-15