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Trends in Body Mass Index and Association With Outcomes in Pediatric Patients on Continuous Flow Ventricular Assist

Kriti Puri1,2, Iki Adachi3, Claire E Bocchini4

  • 1From the Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 30, 2021
PubMed

Insights

Pediatric ventricular assist device (VAD) patients who are overweight or obese do not improve their body mass index (BMI) and often see increases. This highlights a need for further research into abnormal BMI

Area of Science:

  • Pediatric Cardiology
  • Mechanical Circulatory Support
  • Obesity Medicine

Background:

  • Limited data exist on body mass index (BMI) in pediatric ventricular assist device (VAD) patients.
  • Understanding BMI's impact on VAD outcomes is crucial for optimizing care.

Purpose of the Study:

  • To investigate the relationship between BMI categories at VAD implant and clinical outcomes in pediatric patients.
  • To assess changes in BMI percentile during VAD support and their association with complications.

Main Methods:

  • Retrospective single-center cohort study of pediatric patients (≤21 years) on durable continuous-flow VAD support for ≥30 days (2009-2020).
  • Patients classified by BMI percentile at implant: underweight, healthy weight, overweight, and obese.
  • Primary outcomes: hospital mortality, length of stay (LOS). Secondary outcomes: infections, pump thrombosis.

Main Results:

  • Of 72 patients, 17% were obese and 18% overweight at implant; 29% gained BMI categories during support.
  • No significant differences in mortality, LOS, or pump thrombosis across BMI groups.
  • Overweight patients had more non-VAD infections; obese patients required longer VAD support and were less likely to be transplanted.

Conclusions:

  • Pediatric VAD patients who are overweight or obese experience BMI increases during support, not improvements.
  • Abnormal BMI in this population is associated with increased VAD support duration and reduced transplant likelihood.
  • Further research is needed to understand the full impact of abnormal BMI on VAD complications in pediatric patients.

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