The Relation Between Obesity and Mortality in Postcardiotomy Venoarterial Membrane Oxygenation

Heuts, Samuel; Mariani, Silvia; Bussel, Bas C.T. van; Boeken, Udo; Samalavičius, Robertas; Bounader, Karl; Hou, Xiaotong; Bunge, Jeroen J H; Sriranjan, Kogulan; Wiedemann, Dominik; Saeed, Diyar; Pozzi, Mattéo; Loforte, Antonio; Salazar, Leonardo; Meyns, Bart; Mazzeffi, Michael; Matteucci, Sacha; Sponga, Sandro; Sorokin, V. V.; Russo, Claudio; Formica, Francesco; Sakiyalak, Pranya; Fiore, Antonio; Camboni, Daniele; Raffa, Giuseppe Maria; Díaz, R. F.; Wang, I-Wen; Jung, Jae Seung; Bělohlávek, Jan; Pellegrino, Vin; Bianchi, Giacomo; Pettinari, Matteo; Barbone, Alessandro; Garcia, José P; Shekar, Kiran; Whitman, Glenn J.R.; Lorusso, Roberto

doi:10.1016/j.athoracsur.2023.03.025

Cited by 5 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The increased adipose tissue in obese patients can pose challenges during cannulation, as it obscures the underlying vessels and makes it difficult to identify suitable cannulation sites [ 1 , 3 , 6 – 9 , 12 , 19 ]. This may result in suboptimal cannula positioning or vascular injuries during insertion, leading to hemorrhage or improper ECMO flow [ 23 , 29 , 31 ]. Altered respiratory mechanics in obese patients, characterized by reduced lung compliance and increased airway resistance, can impact efficient oxygenation and carbon dioxide removal by the ECMO system [ 23 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Huang,

Lin

2024

BMC Pulm Med

View full text Add to dashboard Cite

Background Extracorporeal membrane oxygenation (ECMO) is used when standard methods of standard treatment methods are not successful. Obese patients present unique challenges during ECMO due to large body size hindering sufficient flows, difficulties with patient positioning and anatomical landmark identification, and restricted radiology scans. This meta-analysis aims to investigate the impact of obesity on the outcomes of patients undergoing ECMO. Methods Databases (PubMed, Embase, and Scopus databases) were searched to identify relevant studies published until July 2023. Data were reported as odds ratios (OR) with 95% confidence interval (CI), and the descriptive data were reported as standard difference of means (SDM) by a random effects model. Results A literature search identified 345 studies. Of them, 18 studies met the inclusion criteria. The findings from the meta-analysis revealed no significant association between obesity and survival outcomes after ECMO (odds ratio (OR): 0.91, 95% confidence interval (CI): 0.70–1.17, p: 0.46). Moreover, no comparative significant differences were found between obese and non-obese individuals on the duration of ECMO procedure (standardized mean difference (SMD): 0.07, -0.03–0.17), length of hospital stay (-0.03, -0.19 to 0.12), and duration of ventilation support (-0.10, -0.44 to 0.24). Conclusion The meta-analysis findings suggest no significant impact of obesity on the survival outcomes after the ECMO procedure. There was no significant impact of obesity on the duration of ECMO procedures, length of hospital stay, and duration of ventilation support.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Huang,

Lin

2024

BMC Pulm Med

View full text Add to dashboard Cite

show abstract

Extracorporeal Membrane Oxygenation for Postcardiotomy Shock: Time to Look for Action Instead of Selection?

Singh¹,

Chung²,

Takeda³

et al. 2023

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study

Bunge,

Mariani,

Meuwese

et al. 2024

Critical Care Medicine

View full text Add to dashboard Cite

Objectives: Most post-cardiotomy (PC) extracorporeal membrane oxygenation (ECMO) runs last less than 7 days. Studies on the outcomes of longer runs have provided conflicting results. This study investigates patient characteristics and short- and long-term outcomes in relation to PC ECMO duration, with a focus on prolonged (> 7 d) ECMO. Design: Retrospective observational cohort study. Setting: Thirty-four centers from 16 countries between January 2000 and December 2020. Patients: Adults requiring post PC ECMO between 2000 and 2020. Interventions: None. Measurements and Main Results: Characteristics, in-hospital, and post-discharge outcomes were compared among patients categorized by ECMO duration. Survivors and nonsurvivors were compared in the subgroup of patients with ECMO duration greater than 7 days. The primary outcome was in-hospital mortality. Two thousand twenty-one patients were included who required PC ECMO for 0–3 days (n = 649 [32.1%]), 4–7 days (n = 776 [38.3%]), 8–10 days (n = 263 [13.0%]), and greater than 10 days (n = 333 [16.5%]). There were no major differences in the investigated preoperative and procedural characteristics among ECMO duration groups. However, the longer ECMO duration category was associated with multiple complications including bleeding, acute kidney injury, arrhythmias, and sepsis. Hospital mortality followed a U-shape curve, with lowest mortality in patients with ECMO duration of 4–7 days (n = 394, 50.8%) and highest in patients with greater than 10 days ECMO support (n = 242, 72.7%). There was no significant difference in post-discharge survival between ECMO duration groups. In patients with ECMO duration greater than 7 days, age, comorbidities, valvular diseases, and complex procedures were associated with nonsurvival. Conclusions: Nearly 30% of PC ECMO patients were supported for greater than 7 days. In-hospital mortality increased after 7 days of support, especially in patients undergoing valvular and complex surgery, or who had complications, although the long-term post-discharge prognosis was comparable to PC ECMO patients with shorter support duration.

show abstract

The Relation Between Obesity and Mortality in Postcardiotomy Venoarterial Membrane Oxygenation

Cited by 5 publications

References 17 publications

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Extracorporeal Membrane Oxygenation for Postcardiotomy Shock: Time to Look for Action Instead of Selection?

Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study

Contact Info

Product

Resources

About