Body mass index and echocardiography in refractory ARDS treated with veno-venous extracorporeal membrane oxygenation
| Autor: | Giovanni Cianchi, Morena Cozzolino, Adriano Peris, Stefano Batacchi, Chiara Lazzeri, Pasquale Bernardo, Manuela Bonizzoli, Paolo Terenzi |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male ARDS medicine.medical_specialty medicine.medical_treatment Biomedical Engineering Medicine (miscellaneous) Overweight Body Mass Index Biomaterials 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Refractory Lv dysfunction Internal medicine medicine Extracorporeal membrane oxygenation Humans Obesity Contraindication Aged Retrospective Studies Respiratory Distress Syndrome business.industry Incidence (epidemiology) 030208 emergency & critical care medicine Middle Aged Prognosis medicine.disease Surgery 030228 respiratory system Echocardiography Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | Journal of Artificial Organs. 20:50-56 |
| ISSN: | 1619-0904 1434-7229 |
| Popis: | The aims of the present investigation, performed in 118 consecutive patients with refractory ARDS treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO), were as follows: (a) to assess ICU mortality in overweight, obese and morbid obese patients in respect to normal weight; (b) to evaluate echocardiographic findings according to BMI subgroups. Echocardiography was performed before VV-ECMO implantation. Forty-five patients (38.1%) showed normal BMI, 37 patients (31.4%) were overweight and the remaining were obese (21.2%), or morbid obese (9.3%). Morbid obese showed the lowest ICU mortality rate (p = 0.003). No differences were detectable among BMI subgroups in echocardiographic findings apart from the fact that obese patients showed the lowest incidence of LV dysfunction (p = 0.015). At stepwise regression analysis the following variables were independent predictor of ICU mortality (when adjusted for age): RV dilatation (OR 4.361, 95 % CI 1.809–10.512, p 30 kg/m2 is common (accounting for one-third of the entire population) but it is not associated with a worse outcome, so that it cannot be considered per se a contraindication to ECMO implantation. The incidence of RV dilatation and failure, which are known to negatively affect prognosis in ARDS patients, were comparable among BMI subgroups. |
| Databáze: | OpenAIRE |
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