Outcomes in Obese Adult Venoarterial Extracorporeal Membrane Oxygenation: A Systematic Review.
J Cardiothorac Vasc AnesthMay 30, 2026 (epub)
Jaclyn N Portelli Tremont, Ricardo Crespo Regalado, Clark Cunningham et al.
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In 30 seconds
This systematic review evaluated outcomes in obese adults undergoing venoarterial ECMO, analyzing data from five studies with 1,196 patients. The analysis found no significant difference in mortality between patients with BMI <30 (60.3%) and BMI ≥30 (58.6%), p = 0.6, suggesting that obesity may not preclude VA-ECMO consideration.
Key findings
- No significant difference in mortality between BMI <30 (60.3%) and BMI ≥30 (58.6%), p = 0.6.
- Acute renal failure occurred in 15.0%-53.3% of patients.
- Major bleeding complications were reported in 7.5%-42.0% of patients.
- One study showed more complications in obese patients (51% vs 25%, p = 0.002).
Why it matters
Understanding the impact of obesity on ECMO outcomes is crucial for clinicians, as it may influence decision-making regarding the use of VA-ECMO in critically ill patients with high BMI.
What to keep in mind
The evidence is limited and heterogeneous, which may affect the reliability of the findings.