Impact of BMI on outcomes in respiratory ECMO: an ELSO registry study

Peetermans, Marijke; Guler, Ipek; Meersseman, Philippe; Wilmer, Alexander; Wauters, Joost; Meyns, Bart; Vlaar, Alexander P.J.; Hermans, Greet

doi:10.1007/s00134-022-06926-4

Cited by 27 publications

(29 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26 Additionally, a more recent 2022 ELSO study of more than 18,000 respiratory failure patients on ECMO (performed after our review was complete) shows that patients with BMIs of greater than or equal to 35 had decreased inpatient mortality and reduced hospital length of stays. 27 Based on our review, there does appear to be at least a trend toward reduced mortality among obese VV ECMO adults, but there is not a clear explanation.…”

Section: Discussionmentioning

confidence: 79%

See 1 more Smart Citation

Outcomes in Obese Adult Veno-Venous Extracorporeal Membrane Oxygenation: A Systematic Review

Reid,

Crespo Regalado,

Carlson

et al. 2023

ASAIO Journal

View full text Add to dashboard Cite

Obesity is associated with an overall increased risk of morbidity and mortality. However, in patients with critical illness, sepsis, and acute respiratory distress syndrome, obesity may be protective, termed “the obesity paradox.” This is a systematic literature review of articles published from 2000 to 2022 evaluating complications and mortality in adults with respiratory failure on veno-venous extracorporeal membrane oxygenation (VV ECMO) based on body mass index (BMI). Eighteen studies with 517 patients were included. Common complications included acute renal failure (175/377, 46.4%), venous thrombosis (175/293, 59.7%), and bleeding (28/293, 9.6%). Of the six cohort studies, two showed improved mortality among obese patients, two showed a trend toward improved mortality, and two showed no difference. Comparing all patients in the studies with BMI of less than 30 to those with BMI of greater than or equal to 30, we noted decreased mortality with obesity (92, 37.1% of BMI <30 vs. 30, 11% of BMI ≥30, p ≤ 0.0001). Obesity may be protective against mortality in adult patients undergoing VV ECMO. Morbid and super morbid obesity should not be considered a contraindication to cannulation, with patients with BMI ≥ 80 surviving to discharge. Complications may be high, however, with higher rates of continuous renal replacement therapy and thrombosis among obese patients.

show abstract

Section: Discussionmentioning

confidence: 79%

“…A more significant percentage of the airway pressure may be diverted to expanding the chest wall in obese patients, leading to decreased transpulmonary pressures and less effective mechanical ventilation. 27,31 Further research is needed to determine why critically ill obese patients have better survival, particularly while on ECMO.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in Obese Adult Veno-Venous Extracorporeal Membrane Oxygenation: A Systematic Review

Reid,

Crespo Regalado,

Carlson

et al. 2023

ASAIO Journal

View full text Add to dashboard Cite

show abstract

“…In our study, ECMO-CRRT survivors were younger, had a higher BMI (similar to other reports in the literature) and had a negative fluid balance. On the other hand, patients with a primary cardiac indication for ECMO and VA ECMO support had increased mortality [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy

Franco Palacios,

Hoxhaj,

Thigpen

et al. 2024

Renal Failure

View full text Add to dashboard Cite

Objective This single center retrospective study aimed to describe the variables associated with outpatient dialysis dependence in extracorporeal membrane oxygenation (ECMO) patients who needed continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) during their hospitalization. Methods Retrospective study of patients who required ECMO-CRRT. Results Between the years of 2016 and 2022, 202 patients required ECMO-CRRT. One hundred and six patients (52.5%) survived their hospitalization and were followed up for a median of 391 [133, 1005] days. Eighty-one patients (76.5%) recovered kidney function and were dialysis-free before hospital discharge. Twenty-five patients (23.5%) were hemodialysis-dependent after hospitalization. On multivariate regression analysis, hyperlipidemia (odds ratio, OR 6.08 [1.67–22]) and CRRT duration (OR 1.09 [1.03–1.15]) were associated with the need for dialysis post-hospitalization. In this group, 16 patients eventually became dialysis-free, after a median of 49 [34.7, 78.5] days. These patients had a higher median baseline glomerular filtration rate (GFR) compared to those who never recovered renal function (93 mL/min/1.73 m 2 [82.4, 104.3] vs. 63.8 mL/min/1.73 m 2 [37.9, 83], p = .009). Their follow-up GFR was lower compared to those who recovered renal function before hospital discharge; (87 mL/min/1.73 m 2 [68.2, 98.9] vs. 99 mL/min/1.73 m 2 [79, 118], p = .07). Conclusions AKI requiring CRRT was associated with high mortality in patients receiving ECMO. Nonetheless, most ECMO survivors became dialysis-free before hospital discharge. Variables associated with the need for outpatient dialysis included hyperlipidemia and prolonged need for CRRT during hospitalization.

show abstract

“…Thus, more systematic and scienti c clinical research is needed to evaluate the effects of maxillary expansion using different expanders. PSM has been extensively used in recent clinical studies to increase the experiment credibility by balance baseline data between groups [21,22]. Therefore, in this study PSM was innovatively introduced to balance confounding factors including sex, CVM stage, DI score, and Angle's classi cation (Table s1), greatly enhancing comparability between the two treated groups.…”

Section: Discussionmentioning

confidence: 99%

Effects of maxillary expansion in mixed dentition with Invisalign First System and Hass: A prospective cohort study

Lü

Zhang

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: This prospective cohort study aimed to compare the dento-skeletal effects of using Invisalign First System with Hass excluding growth factors. Materials and Methods: A total of 51 patients were included in this study: Invisalign First System (First) group (n = 17), Hass group (n = 17), natural growth (NG) group (n = 17), after screening by strict inclusion criteria and propensity score matching (PSM). Research indicators were measured on digital dental casts at baseline (T0) and six-month follow-up (T1), including intercanine width, interpremolar width, second interdeciduous molar width, arch depth, arch perimeter, intercanine alveolar bone width, intermolar alveolar bone width, and molar inclination. Results: In the NG group, there was no statistically significant difference in dento-skeletal indicators. In the First and Hass group, all indicators were significantly increased after treatment. The Hass group showed a greater expansion than First group for intercanine width, first interpremolar width, second interdeciduous molar width and first intermolar mesial width, arch perimeter, intercanine alveolar bone width, intermolar alveolar bone width, and molar inclination (p < 0.05). Whereas, arch depth showed no statistically significant difference between the two groups. Conclusions: 1. Both Hass and First can effectively expand maxillary in mixed dentition. 2. Invisalign First System is a new method of comfortably and effectively acting on maxillary expansion, recommended for patients with aesthetic, arch space management needs and mild to moderate narrowing of the maxillary in mixed dentition. 3. Hass allows a greater expansion, recommended for patients with severe maxillary transverse deficiency. Clinical relevance: The present fndings provide theoretical basis for various clinical treatments regarding maxillary expansion with mixed dentition. Registration number:ChiCTR2200056220, February 1, 2022.

show abstract

Impact of BMI on outcomes in respiratory ECMO: an ELSO registry study

Cited by 27 publications

References 46 publications

Outcomes in Obese Adult Veno-Venous Extracorporeal Membrane Oxygenation: A Systematic Review

Outcomes in Obese Adult Veno-Venous Extracorporeal Membrane Oxygenation: A Systematic Review

Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy

Effects of maxillary expansion in mixed dentition with Invisalign First System and Hass: A prospective cohort study

Contact Info

Product

Resources

About