The Five-Day Trajectory of Nutritional Indicators and Influencing Factors in Adult Patients After VA-ECMO: A Prospective Observational Study.

OBJECTIVE

This study aimed to characterize the 5-day trajectory of nutritional and metabolic profiles and identify influencing factors in adults receiving VA-ECMO support.

METHODS

A total of 46 patients with cardiogenic shock receiving VA-ECMO (2022-2024; median age 50 [IQR: 41.0-63.3]) were prospectively enrolled. Demographic, clinical, nutritional, and metabolic biomarkers were serially collected over 5 days. Multivariate analysis was employed to evaluate longitudinal trends and determinants of change.

RESULTS

Significant dynamic changes were observed in nutritional and metabolic parameters, including serum albumin, neutrophil count, prognostic nutrition index (PNI), triceps skinfold thickness, and mid-upper arm circumference. A marked decline in albumin occurred within the first 48 h (mean differences: -5.663, p = 0.035; -5.728, p = 0.003). Age and hyperlipidemia were independent factors affecting albumin levels (p < 0.001 and p = 0.032, respectively). Progressive reductions in skinfold thickness and arm circumference were noted from day 2 to day 5 (p < 0.001).

CONCLUSIONS

ECMO support is associated with early changes in nutritional status. Rapid albumin decline within 48 h and later anthropometric reductions suggest a need for prompt nutritional monitoring and individualized intervention, though further validation is warranted.

IMPLICATIONS FOR CLINICAL PRACTICE: These findings highlight the critical importance of integrated nutritional and metabolic management initiated early during VA-ECMO support to improve patient outcomes.