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Body mass index does not impact survival in COVID-19 patients requiring veno-venous extracorporeal membrane oxygenation.
Powell, Elizabeth K; Haase, Daniel J; Lankford, Allison; Boswell, Kimberly; Esposito, Emily; Hamera, Joseph; Dahi, Siamak; Krause, Eric; Bittle, Gregory; Deatrick, Kristopher B; Young, Bree Ann C; Galvagno, Samuel M; Tabatabai, Ali.
  • Powell EK; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Haase DJ; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Lankford A; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Boswell K; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Esposito E; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Hamera J; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Dahi S; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Krause E; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Bittle G; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Deatrick KB; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Young BAC; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
  • Galvagno SM; Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Tabatabai A; Department of Emergency Medicine, 12264University of Maryland School of Medicine, Baltimore, MD, USA.
Perfusion ; : 2676591221097642, 2022 Apr 25.
Article in English | MEDLINE | ID: covidwho-1808004
ABSTRACT

INTRODUCTION:

With the increased demand for veno-venous extracorporeal membrane oxygenation (VV ECMO) during the COVID-19 pandemic, guidelines for patient candidacy have often limited this modality for patients with a body mass index (BMI) less than 40 kg/m2. We hypothesize that COVID-19 VV ECMO patients with at least class III obesity (BMI ≥ 40) have decreased in-hospital mortality when compared to non-COVID-19 and non-class III obese COVID-19 VV ECMO populations.

METHODS:

This is a single-center retrospective study of COVID-19 VV ECMO patients from January 1, 2014, to November 30, 2021. Our institution used BMI ≥ 40 as part of a multi-disciplinary VV ECMO candidate screening process in COVID-19 patients. BMI criteria were not considered for exclusion criteria in non-COVID-19 patients. Univariate and multivariable analyses were performed to assess in-hospital mortality differences.

RESULTS:

A total of 380 patients were included in our

analysis:

The COVID-19 group had a lower survival rate that was not statistically significant (65.7% vs.74.9%, p = .07). The median BMI between BMI ≥ 40 COVID-19 and non-COVID-19 patients was not different (44.5 vs 45.5, p = .2). There was no difference in survival between the groups (73.3% vs. 78.5%, p = .58), nor was there a difference in survival between the COVID-19 BMI ≥ 40 and BMI < 40 patients (73.3, 62.7, p= .29). Multivariable logistic regression with the outcome of in-hospital mortality was performed and BMI was not found to be significant (OR 0.99, 95% CI 0.89, 1.01; p = .92).

CONCLUSION:

BMI ≥ 40 was not an independent risk factor for decreased in-hospital survival in this cohort of VV ECMO patients at a high-volume center. BMI should not be the sole factor when deciding VV ECMO candidacy in patients with COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Perfusion Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: 02676591221097642

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Perfusion Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: 02676591221097642