• J. Cardiothorac. Vasc. Anesth. · Aug 2022

    Observational Study

    Effect of Body Mass Index on the Clinical Outcomes of Adult Patients Treated With Venoarterial ECMO for Cardiogenic Shock.

    • Léandre Girard, Fares Djemili, Marjolaine Devineau, Céline Gonzalez, Bérénice Puech, Dorothée Valance, Amélie Renou, Gilbert Dubois, Eric Braunberger, Nicolas Allou, Jérôme Allyn, and Charles Vidal.
    • Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France. Electronic address: leandre.girard.ar@gmail.com.
    • J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt A): 2376-2384.

    ObjectiveCurrent 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.DesignThis was a retrospective and observational study.SettingUniversity hospital.ParticipantsThe study comprised 150 adult patients who underwent VA-ECMO for cardiogenic shock.Measurements And Main ResultsThe primary outcome was intensive care unit (ICU) mortality. Of the 150 included patients, 10 were underweight (BMI < 18.5 kg/m²), 62 were normal weight (BMI = 18.5-24.9 kg/m²), 34 were overweight (BMI = 25.0-29.9 kg/m²), 34 were obese class I (BMI = 30.0-34.9 kg/m²), and 10 were obese class II (BMI = 35.0-39.9 kg/m²). 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.ConclusionThe 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.Copyright © 2021 Elsevier Inc. All rights reserved.

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