Dr Coccola is affiliated with Division of Critical Care, Department of Pediatrics, UH Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio. Dr Remy is affiliated with Division of Critical Care, Department of Pediatrics, UH Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio; and Division of Pulmonary Critical Care, Department of Medicine, University Hospitals of Cleveland and Case Western Reserve University School of Medicine, Cleveland, Ohio. Dr Cheifetz is affiliated with Division of Cardiac Critical Care, Department of Pediatrics, UH Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio.
Respir Care. 2024 Mar 27;69(4):474-481. doi: 10.4187/respcare.11565.
Obesity is increasing in prevalence worldwide and carries a theoretical increased risk of morbidity and mortality in critical illness, including hypercoagulability, thrombosis, and renal dysfunction. Obesity has historically been considered a relative contraindication to candidacy for extracorporeal membrane oxygenation (ECMO); however, recent research has suggested that obesity may be associated with improved outcomes in ECMO. This review was conducted to assess and synthesize the existing literature on ECMO outcomes in the obese population. We searched PubMed, Scopus, and CENTRAL databases for obesity and ECMO outcomes, and articles were screened independently by 2 authors. The selection process yielded 29 articles, with one ambispective and 28 retrospective cohort studies. Analyses of these studies show no evidence of globally increased mortality or complications in obesity. Prospective evaluation is needed to further investigate this relationship, but there is currently no evidence to support using body mass index as exclusionary criteria for ECMO.
肥胖症在全球范围内的患病率不断增加，在危重病中存在理论上增加发病率和死亡率的风险，包括高凝状态、血栓形成和肾功能障碍。肥胖症在历史上被认为是体外膜氧合（ECMO）候选资格的相对禁忌症；然而，最近的研究表明，肥胖症可能与 ECMO 中的改善结局相关。进行这项综述是为了评估和综合肥胖人群中 ECMO 结局的现有文献。我们在 PubMed、Scopus 和 CENTRAL 数据库中搜索了肥胖症和 ECMO 结局的相关文章，并由 2 名作者独立筛选文章。选择过程产生了 29 篇文章，其中 1 篇为前瞻性和 28 篇回顾性队列研究。这些研究的分析表明肥胖症并没有增加死亡率或并发症的全球证据。需要进行前瞻性评估来进一步研究这种关系，但目前没有证据支持使用体重指数作为 ECMO 的排除标准。
