Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort study
2024

Malnutrition in Adult Patients on VA ECMO

Sample size: 197 publication Evidence: moderate

Author Information

Author(s): Pelekhaty Stacy MS, RDN, LDN, Gessler Julie RDN, LDN, Baer Devon RDN, LDN, Rector Raymond CCP, Plazak Michael PharmD, BCCP, Bathula Allison PharmD, BCCP, Wells Chris PhD, PT, CCS, FCCM, Shah Aakash MD, Grazioli Alison MD, Taylor Bradley MD, Griffith Bartley P. MD, Rabin Joseph MD

Primary Institution: University of Maryland Medical Center

Hypothesis

What is the association between malnutrition and outcomes in adult patients requiring venoarterial extracorporeal membrane oxygenation (ECMO)?

Conclusion

Malnutrition is associated with prolonged duration of VA ECMO in adult patients.

Supporting Evidence

  • Malnutrition at any point was associated with longer duration of ECMO.
  • Patients with hospital-acquired malnutrition required a 50% longer duration of ECMO.
  • Preexisting malnutrition was associated with a nonsignificant increase in mortality.

Takeaway

Malnutrition can make patients on a special heart-lung machine called VA ECMO stay on it longer, which can be a problem.

Methodology

This study analyzed data from patients on VA ECMO, assessing malnutrition using the GLIM framework and comparing outcomes based on nutritional status.

Potential Biases

Potential bias due to the subjective nature of malnutrition assessments and the lack of biochemical markers for inflammation.

Limitations

The study was conducted at a single center, which may not represent all ECMO centers, and it was underpowered to fully explore the relationship between malnutrition and mortality.

Participant Demographics

The cohort was 68% male with a median age of 56 years and a median BMI of 29.9.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1016/j.xjon.2024.09.029

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