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Master Thesis

Effet de l’indice de masse corporelle sur le devenir en réanimation de patients traités par ECMO veino-artérielle pour choc cardiogénique

Abstract : Background: The prognosis of obese patients in intensive care is subject to debate. However, obesity is still considered a relative contraindication to veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock. Therefore, we investigated the link between body mass index (BMI) and mortality in intensive care. Methods: In this retrospective and single-center study, all patients undergoing VA-ECMO between January 2014 and December 2019 were included. The primary outcome was mortality in intensive care unit. Results: Among the 150 patients included and according to the WHO’s definitions, 10 patients were underweight (BMI < 18.5), 62 were normal weight (BMI = 18.5-24.9), 34 were overweight (BMI = 25.0-29.9), 34 were class I obese (BMI = 30.0-34.9) and 10 were class II obese (BMI = 35.0-39.9). The mortality rate was 62% (underweight, 70%; normal, 53%; overweight, 65%; class I obese, 71%; class II obese, 70%). After multivariable logistic regression, BMI was not associated with ICU mortality (OR 0.991 [0.92 - 1.07], p = 0.8). Analysis by BMI class showed a more unfavorable trend in underweight patients (OR 3.58 [0.816-19.6], p = 0.11). There were no significant differences in incidences of nosocomial infection, bleeding and stroke among the different weight categories. Conclusion: BMI was not associated with mortality in our study. Obesity alone should not be an exclusion criterion for VA-ECMO. However, a more unfavorable trend appeared in underweight patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03186333
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Submitted on : Wednesday, March 31, 2021 - 8:13:29 AM
Last modification on : Tuesday, October 19, 2021 - 5:56:43 PM
Long-term archiving on: : Thursday, July 1, 2021 - 6:06:49 PM

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  • HAL Id : dumas-03186333, version 1

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Léandre Girard. Effet de l’indice de masse corporelle sur le devenir en réanimation de patients traités par ECMO veino-artérielle pour choc cardiogénique. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03186333⟩

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