Mortality in Patients with Obesity and Acute Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation: The Multicenter ECMObesity Study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue American journal of respiratory and critical care medicine Année : 2023

Mortality in Patients with Obesity and Acute Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation: The Multicenter ECMObesity Study

Darya D. Rudym
  • Fonction : Auteur
Craig R. Rackley
  • Fonction : Auteur
Giacomo Grasselli
Michaela R. Anderson
  • Fonction : Auteur
Matthew R. Baldwin
  • Fonction : Auteur
Jeremy R. Beitler
  • Fonction : Auteur
Cara L. Agerstrand
  • Fonction : Auteur
Alexis L. Serra
  • Fonction : Auteur
Lisle A. Winston
  • Fonction : Auteur
Desiree K. Bonadonna
  • Fonction : Auteur
Natalie H. Yip
Logan J. Emerson
  • Fonction : Auteur
Amy L. Dzierba
  • Fonction : Auteur
Joshua Robert Sonett
  • Fonction : Auteur
Darryl C. Abrams
  • Fonction : Auteur
Niall D. Ferguson
Matthew D. Bacchetta
  • Fonction : Auteur
Daniel M. Brodie
  • Fonction : Auteur

Résumé

Rationale: Patients with obesity are at increased risk for developing acute respiratory distress syndrome (ARDS). Some centers consider obesity a relative contraindication to receiving extracorporeal membrane oxygenation (ECMO) support, despite growing implementation of ECMO for ARDS in the general population. Objectives: To investigate the association between obesity and mortality in patients with ARDS receiving ECMO. Methods: In this large, international, multicenter, retrospective cohort study, we evaluated the association of obesity, defined as body mass index ⩾ 30 kg/m2, with ICU mortality in patients receiving ECMO for ARDS by performing adjusted multivariable logistic regression and propensity score matching. Measurements and Main Results: Of 790 patients with ARDS receiving ECMO in our study, 320 had obesity. Of those, 24.1% died in the ICU, compared with 35.3% of patients without obesity (P < 0.001). In adjusted models, obesity was associated with lower ICU mortality (odds ratio, 0.63 [95% confidence interval, 0.43-0.93]; P = 0.018). Examined as a continuous variable, higher body mass index was associated with decreased ICU mortality in multivariable regression (odds ratio, 0.97 [95% confidence interval, 0.95-1.00]; P = 0.023). In propensity score matching of 199 patients with obesity to 199 patients without, patients with obesity had a lower probability of ICU death than those without (22.6% vs. 35.2%; P = 0.007). Conclusions: Among patients receiving ECMO for ARDS, those with obesity had lower ICU mortality than patients without obesity in multivariable and propensity score matching analyses. Our findings support the notion that obesity should not be considered a general contraindication to ECM
Fichier non déposé

Dates et versions

hal-04229509 , version 1 (05-10-2023)

Identifiants

Citer

Darya D. Rudym, Tài Pham, Craig R. Rackley, Giacomo Grasselli, Michaela R. Anderson, et al.. Mortality in Patients with Obesity and Acute Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation: The Multicenter ECMObesity Study. American journal of respiratory and critical care medicine, 2023, 208 (6), pp.685-694. ⟨10.1164/rccm.202212-2293OC⟩. ⟨hal-04229509⟩
21 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More