Suhel Al-Soufi Hergen Buscher Nguyen Dinh Nguyen Peter Rycus Priya Nair Lack of association between body weight and mortality in patients on veno-venous extracorporeal membrane oxygenation Received: 29 April 2013 Accepted: 12 July 2013 Published online: 7 August 2013 Ó Springer-Verlag Berlin Heidelberg and ESICM 2013 Electronic supplementary material The online version of this article (doi:10.1007/s00134-013-3028-3) contains supplementary material, which is available to authorized users. S. Al-Soufi ( ) ) Á H. Buscher Á P. Nair Intensive Care Unit, St Vincent’s Hospital, Victoria Street Darlinghurst, Sydney, NSW 2010, Australia e-mail: suhelsoufi@gmx.de Tel.: ?61-83822581 Fax: ?61-83833947 N. D. Nguyen Garvan Institute of Medical Research, Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia P. Rycus Extracorporeal Life Support Organization, 2800 Plymouth Rd, Ann Arbor, MI, USA Abstract Purpose: To analyse the association of body weight with hos- pital mortality of adult patients supported with veno-venous extra- corporeal membrane oxygenation (VV ECMO). Methods: Retrospec- tive analysis of the international Extracorporeal Life Support Organi- zation (ELSO) registry. Univariate and multivariable logistic regression analyses were used to estimate the odds ratio (OR) of hospital death for each body weight quartile. Adjust- ment was made for demographic, physiologic and ECMO-related char- acteristics. We undertook a similar analysis for the subgroup of patients with confirmed H1N1 infection on VV ECMO. Results: The study group consisted of 1,334 adult patients supported with VV ECMO between 2005 and 2011 with a med- ian (Q1, Q3) body weight of 80 kg (69, 101 kg). Univariate analysis identified increased body weight to be associated with a reduced risk of death. In multivariable analysis, only age greater than 53 years, primary diagnosis other than pneumonia and intubation time longer than 3 days prior to initiation of ECMO were independent risk factors for mortality, whereas the association between high body weight and adjusted risk of death (OR 0.73, 95 % CI 0.52–1.04, P = 0.08) was no longer statistically significant. The body weight of the 196 patients with confirmed H1N1 infection was significantly higher than that of the remaining study group. Body weight was not signifi- cantly associated with risk of death for these patients either (univariate OR for Q4 vs. Q1: 0.75, 95 % CI 0.33–1.72, P = 0.49). Conclu- sions: Increased body weight was not a risk factor for hospital mortality in adult patients who required support with VV ECMO. High body weight should therefore not be regarded as a contraindication to initiation of VV ECMO in adult patients. Data col- lection and reporting that include patient height in addition to body weight would facilitate future research into the association of obes- ity with outcome of ECMO patients. Keywords Extracorporeal membrane oxygenation Á ECMO Á Body weight Á Influenza A H1N1 Á Mortality Á Obesity Introduction The prevalence of overweight and obesity has risen over recent decades and is high in most regions of the world [1]. This trend is expected to continue with the majority of adults in the USA, UK and Australia projected to be overweight by 2020 [2]. Obesity has been identified as a risk factor for the development of acute respiratory Intensive Care Med (2013) 39:1995–2002 DOI 10.1007/s00134-013-3028-3 ORIGINAL