Honzawa Hiroshi, Taniguchi Hayato, Ogawa Fumihiro, Oi Yasufumi, Abe Takeru, Takeuchi Ichiro
Emergency Care Department Yokohama City University Hospital Yokohama Japan.
Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan.
Acute Med Surg. 2023 Jul 17;10(1):e871. doi: 10.1002/ams2.871. eCollection 2023 Jan-Dec.
Although the obesity paradox is known for various diseases, including cancer and acute respiratory distress syndrome, little is known about veno-venous extracorporeal membrane oxygenation (VV-ECMO) in patients with coronavirus disease 2019 (COVID-19). In this study, we aimed to investigate the association between body mass index (BMI) and prognosis in critical patients with COVID-19 requiring VV-ECMO.
We conducted a retrospective observational single-center study at Yokohama City University Civic General Medical Center between March 2020 and October 2021. Participants were patients with COVID-19 who required VV-ECMO. They were classified into two groups: BMI ≤30 kg/m and >30 kg/m.
In total, 23 patients were included in the analysis, with a median BMI of 28.7 kg/m. Overall, 22 patients were successfully weaned from the ECMO. When comparing the two groups, there was a trend toward fewer days from onset to ECMO induction in the BMI >30 kg/m group. Moreover, the two groups had a similar prognosis. There were no statistically significant differences in the number of days from onset to hospitalization or the duration of ECMO induction between the groups.
VV-ECMO induction for patients with COVID-19 may lead to earlier indications in patients with BMI >30 kg/m than in those with BMI ≤30 kg/m.
尽管肥胖悖论在包括癌症和急性呼吸窘迫综合征在内的多种疾病中都有体现，但对于2019冠状病毒病（COVID-19）患者的静脉-静脉体外膜肺氧合（VV-ECMO）情况却知之甚少。在本研究中，我们旨在调查体重指数（BMI）与需要VV-ECMO的COVID-19重症患者预后之间的关联。
我们于2020年3月至2021年10月在横滨市立大学市民综合医疗中心进行了一项回顾性观察单中心研究。参与者为需要VV-ECMO的COVID-19患者。他们被分为两组：BMI≤30kg/m²和>30kg/m²。
总共23名患者纳入分析，BMI中位数为28.7kg/m²。总体而言，22名患者成功脱离ECMO。比较两组时，BMI>30kg/m²组从发病到开始使用ECMO的天数有减少趋势。此外，两组预后相似。两组在从发病到住院的天数或开始使用ECMO的持续时间方面无统计学显著差异。
对于COVID-19患者，与BMI≤30kg/m²的患者相比，BMI>30kg/m²的患者进行VV-ECMO治疗可能会有更早的指征。
