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J Pediatr Intensive Care 2017; 06(02): 109-116
DOI: 10.1055/s-0036-1584681
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Childhood Obesity and Extracorporeal Membrane Oxygenation: Special Considerations for Successful Outcomes

Amit Iyengar
1   David Geffen School of Medicine, University of California, Los Angeles, California, United States
,
Allen Zhu
1   David Geffen School of Medicine, University of California, Los Angeles, California, United States
,
Jessica Samson
2   Department of Perfusion Services, University of California, Los Angeles, California, United States
,
Brian Reemtsen
3   Department of Cardiothoracic Surgery, Ronald Reagan Medical Center, University of California, Los Angeles, California, United States
,
Reshma Biniwale
3   Department of Cardiothoracic Surgery, Ronald Reagan Medical Center, University of California, Los Angeles, California, United States
› Author Affiliations
Further Information

Publication History

07 October 2015

19 March 2016

Publication Date:
24 June 2016 (online)

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Abstract

The effects of obesity on venoarterial extracorporeal membrane oxygenation (VA-ECMO) outcomes in pediatric population are unknown. We performed retrospective analysis of 41 children (age 2–18 years) undergoing VA-ECMO. The percentage difference between actual body weight and lean body weight, referred to as Δmass, was calculated. Ratios of Δmass to ECMO flow were calculated at 4 and 24 hours. In patients with Δmass:flow ≥ 0.1 at 4 hours, higher 24-hour lactates (20.0 vs. 14.5 mg/dL; p = 0.002) and inotrope scores (17.3 vs. 11.2; p = 0.015) were observed. However, elevated Δmass:flow was not associated with mortality, and in-hospital mortality rates between groups were similar (53 vs. 45%; p = 0.647). In obese pediatric patients requiring VA-ECMO, increased flow is necessary to avoid complications of hypoperfusion and related complications.

Keywords

VA-ECMO - obesity - children
 

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