Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective
Objective: To evaluate malnutrition and its association with outcomes in adult patients requiring venoarterial (VA) extracorporeal membrane oxygenation (ECMO). Methods: Patients cannulated for VA ECMO between January 1, 2020, and January 1, 2023, were screened. Patients on ECMO for <48 hours or w...
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Elsevier
2024-12-01
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| Series: | JTCVS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273624003462 |
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| author | Stacy Pelekhaty, MS, RDN, LDN Julie Gessler, RDN, LDN Devon Baer, RDN, LDN Raymond Rector, CCP Michael Plazak, PharmD, BCCP Allison Bathula, PharmD, BCCP Chris Wells, PhD, PT, CCS, FCCM Aakash Shah, MD Alison Grazioli, MD Bradley Taylor, MD Bartley P. Griffith, MD Joseph Rabin, MD |
| author_facet | Stacy Pelekhaty, MS, RDN, LDN Julie Gessler, RDN, LDN Devon Baer, RDN, LDN Raymond Rector, CCP Michael Plazak, PharmD, BCCP Allison Bathula, PharmD, BCCP Chris Wells, PhD, PT, CCS, FCCM Aakash Shah, MD Alison Grazioli, MD Bradley Taylor, MD Bartley P. Griffith, MD Joseph Rabin, MD |
| author_sort | Stacy Pelekhaty, MS, RDN, LDN |
| collection | DOAJ |
| description | Objective: To evaluate malnutrition and its association with outcomes in adult patients requiring venoarterial (VA) extracorporeal membrane oxygenation (ECMO). Methods: Patients cannulated for VA ECMO between January 1, 2020, and January 1, 2023, were screened. Patients on ECMO for <48 hours or without a nutritional evaluation were excluded. Demographic and anthropometric data were collected retrospectively. Malnutrition assessments were conducted using the Global Leadership Initiative on Malnutrition framework. Outcomes analyzed were duration of ECMO and in-hospital mortality. Patients were stratified by admission and discharge nutritional status for analysis. Baseline characteristics were controlled for with propensity score matching. Results: Data from 197 patients was analyzed. The cohort was 68% male. The median duration of ECMO was 139.5 hours (interquartile range [IQR], 94.8-257 hours), and mortality was 35%. Thirty-three patients presented with malnutrition, and 61 developed hospital-acquired malnutrition, for an incidence of 47.7%. Malnutrition at any point was associated with longer duration of ECMO (median, 180 hours [IQR, 107.8-335.8 hours] vs 120 hours [IQR, 90-185.8 hours]; P < .001). Patients with hospital-acquired malnutrition required a 50% longer duration of ECMO (median, 182.5 hours [IQR, 101.5-367 hours] vs 123 hours [IQR, 90.8-211.5 hours]; P < .001). Preexisting malnutrition was associated with a nonsignificant increase in mortality (48.2% vs 32.9%; P = .13), which was similar after 3:1 propensity score matching (43.3% vs 35.4%; P = .44). Conclusions: In adult patients, malnutrition appears to be associated with prolonged duration of VA ECMO. Adequately powered studies are needed to further investigate the relationship between malnutrition and mortality. |
| format | Article |
| id | doaj-art-2e25b4dced54422d95c6bdbf84a33d4a |
| institution | Kabale University |
| issn | 2666-2736 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj-art-2e25b4dced54422d95c6bdbf84a33d4a2024-12-15T06:17:02ZengElsevierJTCVS Open2666-27362024-12-01223846Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspectiveStacy Pelekhaty, MS, RDN, LDN0Julie Gessler, RDN, LDN1Devon Baer, RDN, LDN2Raymond Rector, CCP3Michael Plazak, PharmD, BCCP4Allison Bathula, PharmD, BCCP5Chris Wells, PhD, PT, CCS, FCCM6Aakash Shah, MD7Alison Grazioli, MD8Bradley Taylor, MD9Bartley P. Griffith, MD10Joseph Rabin, MD11Department of Clinical Nutrition, University of Maryland Medical Center, Baltimore, Md; Address for reprints: Stacy Pelekhaty, MS, RDN, LDN, Department of Clinical Nutrition, University of Maryland Medical Center, 22. S Greene St, Baltimore, MD 21201.Department of Clinical Nutrition, University of Maryland Medical Center, Baltimore, MdDepartment of Clinical Nutrition, University of Maryland Medical Center, Baltimore, MdDepartment Perioperative Services, University of Maryland Medical Center, Baltimore, MdDepartment of Pharmaceutical Services, University of Maryland Medical Center, Baltimore, MdDepartment of Pharmaceutical Services, University of Maryland Medical Center, Baltimore, MdDepartment of Rehabilitation Services, University of Maryland Medical Center, Baltimore, MdDepartment of Cardiothoracic Surgery, University of Maryland Medical Center, Baltimore, MdDepartment of Medicine, University of Maryland School of Medicine, Baltimore, MdDivision of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MdDivision of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MdDepartment of Surgery, University of Maryland School of Medicine, Baltimore, MdObjective: To evaluate malnutrition and its association with outcomes in adult patients requiring venoarterial (VA) extracorporeal membrane oxygenation (ECMO). Methods: Patients cannulated for VA ECMO between January 1, 2020, and January 1, 2023, were screened. Patients on ECMO for <48 hours or without a nutritional evaluation were excluded. Demographic and anthropometric data were collected retrospectively. Malnutrition assessments were conducted using the Global Leadership Initiative on Malnutrition framework. Outcomes analyzed were duration of ECMO and in-hospital mortality. Patients were stratified by admission and discharge nutritional status for analysis. Baseline characteristics were controlled for with propensity score matching. Results: Data from 197 patients was analyzed. The cohort was 68% male. The median duration of ECMO was 139.5 hours (interquartile range [IQR], 94.8-257 hours), and mortality was 35%. Thirty-three patients presented with malnutrition, and 61 developed hospital-acquired malnutrition, for an incidence of 47.7%. Malnutrition at any point was associated with longer duration of ECMO (median, 180 hours [IQR, 107.8-335.8 hours] vs 120 hours [IQR, 90-185.8 hours]; P < .001). Patients with hospital-acquired malnutrition required a 50% longer duration of ECMO (median, 182.5 hours [IQR, 101.5-367 hours] vs 123 hours [IQR, 90.8-211.5 hours]; P < .001). Preexisting malnutrition was associated with a nonsignificant increase in mortality (48.2% vs 32.9%; P = .13), which was similar after 3:1 propensity score matching (43.3% vs 35.4%; P = .44). Conclusions: In adult patients, malnutrition appears to be associated with prolonged duration of VA ECMO. Adequately powered studies are needed to further investigate the relationship between malnutrition and mortality.http://www.sciencedirect.com/science/article/pii/S2666273624003462VA ECMOmalnutritionnutrition |
| spellingShingle | Stacy Pelekhaty, MS, RDN, LDN Julie Gessler, RDN, LDN Devon Baer, RDN, LDN Raymond Rector, CCP Michael Plazak, PharmD, BCCP Allison Bathula, PharmD, BCCP Chris Wells, PhD, PT, CCS, FCCM Aakash Shah, MD Alison Grazioli, MD Bradley Taylor, MD Bartley P. Griffith, MD Joseph Rabin, MD Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective JTCVS Open VA ECMO malnutrition nutrition |
| title | Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective |
| title_full | Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective |
| title_fullStr | Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective |
| title_full_unstemmed | Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective |
| title_short | Malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation: A descriptive cohort studyCentral MessagePerspective |
| title_sort | malnutrition in adult patients treated with venoarterial extracorporeal membrane oxygenation a descriptive cohort studycentral messageperspective |
| topic | VA ECMO malnutrition nutrition |
| url | http://www.sciencedirect.com/science/article/pii/S2666273624003462 |
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