Obesity and Extracorporeal Membrane Oxygenation.

Area of Science:

• Critical Care Medicine
• Cardiopulmonary Support
• Obesity Medicine

Background:

• Rising global obesity rates present challenges in critical care.
• Obesity is theoretically linked to increased morbidity and mortality in critical illness.
• Historically, obesity was a contraindication for extracorporeal membrane oxygenation (ECMO).

Purpose of the Study:

• To synthesize current literature on extracorporeal membrane oxygenation (ECMO) outcomes in obese patients.
• To evaluate the association between obesity and outcomes in patients requiring ECMO.
• To determine if body mass index should be an exclusionary criterion for ECMO.

Main Methods:

• Systematic literature search of PubMed, Scopus, and CENTRAL databases.
• Inclusion of studies examining obesity and ECMO outcomes.
• Independent screening and selection of articles by two authors.

Main Results:

• Review of 29 articles (1 ambispective, 28 retrospective cohort studies).
• Analysis revealed no global increase in mortality or complications associated with obesity in ECMO patients.
• No current evidence supports using body mass index as an exclusionary criterion for ECMO.

Conclusions:

• Existing literature does not support increased mortality or complications in obese ECMO patients.
• Further prospective research is needed to fully understand the relationship between obesity and ECMO outcomes.
• Body mass index should not be used as an exclusionary factor for ECMO candidacy based on current evidence.