Obesity and Extracorporeal Membrane Oxygenation (ECMO): Analysis of Outcomes.

Autor: Ripoll JG; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN., ElSaban M; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN., Nabzdyk CS; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA., Balakrishna A; Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN., Villavicencio MA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN., Calderon-Rojas RD; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN., Ortoleva J; Department of Anesthesiology, Boston Medical Center, Boston, MA., Chang MG; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA., Bittner EA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA., Ramakrishna H; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN. Electronic address: ramakrishna.harish@mayo.edu.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2024 Jan; Vol. 38 (1), pp. 285-298. Date of Electronic Publication: 2023 Oct 21.
DOI: 10.1053/j.jvca.2023.10.025
Abstrakt: Traditionally, patients with obesity have been deemed ineligible for extracorporeal life support (ELS) therapies such as extracorporeal membrane oxygenation (ECMO), given the association of obesity with chronic health conditions that contribute to increased morbidity and mortality. Nevertheless, a growing body of literature suggests the feasibility, efficacy, and safety of ECMO in the obese population. This review provides an in-depth analysis of the current literature assessing the effects of obesity on outcomes among patients supported with ECMO (venovenous [VV] ECMO in noncoronavirus disease 2019 and coronavirus disease 2019 acute respiratory distress syndrome, venoarterial [VA] ECMO, and combined VV and VA ECMO), offer a possible explanation of the current findings on the basis of the obesity paradox phenomenon, provides a framework for future studies addressing the use of ELS therapies in the obese patient population, and provides guidance from the literature for many of the challenges related to initiating, maintaining, and weaning ELS therapy in patients with obesity.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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