Evidence map›Paper›PMID 42371000›Full record

ReviewIntensive care medicine2026

ECMO for patients with obesity: evidence and practice.

Quentin Moyon, Greet Hermans, Darryl Abrams, Cara Agerstrand, Michaela R Anderson, Audrey De Jong, Eddy Fan, Niall D Ferguson, Giacomo Grasselli, Samir Jaber and 6 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Quentin Moyon *INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France.ORCID http://orcid.org/0000-0002-0223-5191
Greet Hermans *Medical Intensive Care Units, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0001-5340-1500
Darryl AbramsDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, USA.ORCID http://orcid.org/0000-0001-9073-3897
Cara AgerstrandDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, USA.ORCID http://orcid.org/0000-0002-9676-2709
Michaela R AndersonDivision of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, USA.ORCID http://orcid.org/0000-0001-9274-7643
Audrey De JongDepartment of Anesthesia and Intensive Care Unit, PhyMedExp, Inserm, CNRS, CHRU de Montpellier, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, France.ORCID http://orcid.org/0000-0002-3413-2752
Eddy FanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.ORCID http://orcid.org/0000-0002-1210-9914
Niall D FergusonInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.ORCID http://orcid.org/0000-0002-6213-5264
Giacomo GrasselliDepartment of Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.ORCID http://orcid.org/0000-0002-1735-1400
Samir JaberDepartment of Anesthesia and Intensive Care Unit, PhyMedExp, Inserm, CNRS, CHRU de Montpellier, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, France.ORCID http://orcid.org/0000-0002-7257-8069
Pauline Y NgAdult Intensive Care Unit, Queen Mary Hospital, Hong Kong, China.ORCID http://orcid.org/0000-0001-6671-5963
Tai PhamGroupe de Recherche Clinique CARMAS, Université Paris-Est-Créteil (UPEC), Créteil, France.ORCID http://orcid.org/0000-0002-4373-0711
Darya RudymDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University Langone Medical Center, New York, USA.ORCID http://orcid.org/0000-0002-7371-9804
Matthieu SchmidtINSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France.ORCID http://orcid.org/0000-0002-2931-4412
Alain Combes *INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France. alain.combes@aphp.fr.ORCID http://orcid.org/0000-0002-6030-3957
Daniel Brodie *Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.ORCID http://orcid.org/0000-0002-0813-3145

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeObesity is increasingly encountered among patients requiring extracorporeal membrane oxygenation (ECMO) for severe respiratory or cardiac failure. It alters respiratory and cardiovascular physiology and drug pharmacokinetics and introduces technical and logistical challenges that may complicate patient selection, ECMO initiation, cannulation, anticoagulation, and monitoring. This review summarizes current evidence regarding the epidemiology, physiological implications, outcomes, and management of obesity in patients supported with veno-venous (VV) or veno-arterial (VA) ECMO.

resultsAvailable evidence, largely retrospective and based on body mass index classifications, suggests that obesity should not be considered a contraindication to VV-ECMO, with outcomes comparable to or potentially better than those of patients without obesity. However, obesity-related respiratory mechanics may exaggerate the apparent severity of lung injury, emphasizing the need for optimized conventional ARDS management, including appropriate ventilatory strategies and prone positioning, before ECMO initiation. In contrast, outcomes during VA-ECMO are more heterogeneous, particularly in extracorporeal cardiopulmonary resuscitation (ECPR), and may be influenced by patient selection, comorbidities, and timing of support. Obesity also creates important technical challenges requiring individualized cannulation, anticoagulation, and perfusion strategies.

conclusionObesity alone should not preclude access to ECMO, particularly VV-ECMO. Successful management requires anticipation of obesity-related challenges, appropriate infrastructure, and structured multidisciplinary protocols. Further prospective studies are needed to clarify obesity-specific risks, optimize management strategies, and evaluate long-term outcomes.

Indexed as

Extracorporeal Membrane OxygenationHeart FailureObesityRespiratory Distress SyndromeRespiratory InsufficiencyBody Mass IndexHumansAcute respiratory distress syndromeCardiogenic shockExtracorporeal cardiopulmonary resuscitationExtracorporeal life supportObesity

Identifiers

PMID42371000

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.