New study supports use of ECMO for critically ill patients with obesity

LOS ANGELES - Adults with obesity may benefit from the use of extracorporeal membrane oxygenation (ECMO), an advanced form of breathing support, when in intensive care for respiratory failure, according to a new study funded by the US National Institutes of Health (NIH).

ECMO's use was previously questioned for patients with obesity due to the belief that it may complicate treatment. However, the current findings, which published in the American Journal of Respiratory and Critical Care Medicine, show that patients with obesity who received ECMO for acute respiratory distress syndrome (ARDS) had lower mortality rates compared to patients with ARDS without obesity who received ECMO.

In this study, researchers retrospectively reviewed data from 790 patients from more than 20 medical centers across 10 countries who received ECMO for ARDS, a critical lung injury. Among these patients, 320 had obesity.

They found 24 percent of patients with obesity died in the intensive care unit compared to 35 percent of patients without obesity. The authors could not control for all variables among the larger group analysis, including disease severity. However, they conclude the findings support the concept that obesity, a risk factor for ARDS, should not factor into treatment decisions for ECMO.

"The results of this research open up new questions about how obesity affects outcomes in critical illness to inform evidence-based treatment approaches," said James P. Kiley, director of the US Division of Lung Diseases at the National Heart, Lung, and Blood Institute, which funded the study. Enditem