{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:59:10Z","timestamp":1780901950269,"version":"3.54.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extracorporeal membrane oxygenation (ECMO) is an advanced life support modality associated with global mortality rates ranging from 48.7 to 76.38%. However, a significant knowledge gap remains regarding the specific impact of comorbidities on patient prognosis, particularly within middle-income settings in Latin America, which are characterized by substantial underreporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the relationship between comorbidities and 30-day mortality in patients receiving ECMO support, distinguishing between venoarterial (VA) and venovenous (VV) configurations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A cross-sectional cohort study was conducted on 436 adult patients requiring ECMO support at a high-complexity institution in Colombia between 2019 and 2024. Comorbidities were assessed using the Charlson Comorbidity Index (CCI). The association with mortality was quantified using Odds Ratios (OR), and prevalence was visualized using a \u201cComorbidome\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 420 patients were included, with a mean age of 43.7 (SD:13.0) years and an overall mortality rate of 30%. In the overall ECMO cohort, the most frequent comorbidities were anemia (47.7%), obesity (32.1%), and metabolic disorders (22.0%). Regarding cannulation strategies, VA configuration accounted for 36% of cases, while VV accounted for 64%. Conditions most strongly associated with overall mortality included human immunodeficiency virus (HIV) infection (OR 3.60), chronic kidney disease (OR 2.13), and hypertension (OR 1.68). Mortality associations were modality-specific: in VA-ECMO, chronic kidney disease and cancer presented the highest odds (OR 2.92), whereas in VV-ECMO, HIV infection showed the strongest association (OR 2.44).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-existing comorbidities, particularly HIV, chronic kidney disease, and hypertension, are strongly associated with mortality in this ECMO population. Identifying these conditions and their modality-specific differences is crucial for optimizing candidate selection and guiding clinical management in Latin American intensive care units.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1829427","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:21:04Z","timestamp":1780899664000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comorbidities in extracorporeal membrane oxygenation: a comorbidome-based analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Henry","family":"Robayo-Amortegui","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundaci\u00f3n Cl\u00ednica Shaio","place":["Bogot\u00e1, D.C, Colombia"]},{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Hern\u00e1ndez-Puentes","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"P\u00e9rez-Garz\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundaci\u00f3n Cl\u00ednica Shaio","place":["Bogot\u00e1, D.C, Colombia"]},{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Tuta-Quintero","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Giraldo-Bejarano","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundaci\u00f3n Cl\u00ednica Shaio","place":["Bogot\u00e1, D.C, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana","family":"Lozano-Torres","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundaci\u00f3n Cl\u00ednica Shaio","place":["Bogot\u00e1, D.C, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Granados-Burgos","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Quintero-Altare","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Jaramillo","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundaci\u00f3n Cl\u00ednica Shaio","place":["Bogot\u00e1, D.C, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alirio","family":"Bastidas-Goyes","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Malag\u00f3n-Tarqui","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Poveda-Henao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Extracorporeal Life Support Unit, Fundaci\u00f3n Cl\u00ednica Shaio","place":["Bogot\u00e1, D.C, Colombia"]},{"name":"School of Medicine, Universidad de La Sabana","place":["Ch\u00eda, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.ajem.2025.06.007","article-title":"Extracorporeal membrane oxygenation (ECMO): a narrative review for the emergency clinician","volume":"96","author":"Condella","year":"2025","journal-title":"Am J Emerg Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.cnc.2025.02.006","article-title":"Extracorporeal membrane oxygenation: consideration of human factors in intensive care patients","volume":"37","author":"Eyler","year":"2025","journal-title":"Crit Care Nurs Clin North Am."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e0300713","DOI":"10.1371\/journal.pone.0300713","article-title":"Impact of extracorporeal membrane oxygenation-related complications on in-hospital mortality","volume":"19","author":"Byun","year":"2024","journal-title":"PLoS ONE."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2395450","DOI":"10.1080\/0886022X.2024.2395450","article-title":"Risk factors for mortality in patients receiving extracorporeal membrane oxygenation","volume":"46","author":"Wang","year":"2024","journal-title":"Ren Fail."},{"key":"B5","doi-asserted-by":"publisher","first-page":"120","DOI":"10.4103\/jmedsci.jmedsci_128_21","article-title":"Age and comorbidities as predictors of hospital mortality in adult patients who receive extracorporeal membrane oxygenation therapy: a population-based study","volume":"42","author":"Yeh","year":"2022","journal-title":"J Med Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1164\/rccm.201311-2023OC","article-title":"Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure. The Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score","volume":"189","author":"Schmidt","year":"2014","journal-title":"Am J Respir Crit Care Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2246","DOI":"10.1093\/eurheartj\/ehv194","article-title":"Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score","volume":"36","author":"Schmidt","year":"2015","journal-title":"Eur Heart J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5170","DOI":"10.3390\/jcm13175170","article-title":"Vascular complications in extracorporeal membrane oxygenation-a narrative review","volume":"13","author":"Hart","year":"2024","journal-title":"J Clin Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"410","DOI":"10.5935\/0103-507X.20190063","article-title":"Extracorporeal membrane oxygenation: a literature review","volume":"31","author":"Chaves RC de","year":"2019","journal-title":"Rev Bras Ter Intensiva."},{"key":"B10","doi-asserted-by":"publisher","first-page":"240119","DOI":"10.1183\/20734735.0119-2024","article-title":"Extracorporeal membrane oxygenation for adults with respiratory failure secondary to cardiorespiratory disease: evolving indications and clinical practice","volume":"21","author":"Ocean","year":"2025","journal-title":"Breathe."},{"key":"B11","doi-asserted-by":"publisher","first-page":"57","DOI":"10.5935\/2965-2774.20230350-en","article-title":"Knowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey","volume":"35","author":"J\u00fanior","year":"2023","journal-title":"Critical Care Science."},{"key":"B12","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1001\/jamasurg.2021.0528","article-title":"Reporting guidelines for observational studies","volume":"156","author":"Ghaferi","year":"2021","journal-title":"JAMA Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"B14","volume-title":"Applied Logistic Regression","author":"Hosmer","year":"2004"},{"key":"B15","doi-asserted-by":"publisher","first-page":"448","DOI":"10.7705\/biomedica.4333","article-title":"\u00bfResponde la Resoluci\u00f3n 8430 de 1993 a las necesidades actuales de la \u00e9tica de la investigaci\u00f3n en salud con seres humanos en Colombia?","volume":"39","author":"Mateus","year":"2019","journal-title":"Biomedica."},{"key":"B16","doi-asserted-by":"publisher","first-page":"502129","DOI":"10.1016\/j.medine.2025.502129","article-title":"Experience with extracorporeal membrane oxygenation support in Latin America between 2016 and 2020","volume":"49","author":"Pizarro","year":"2025","journal-title":"Medicina Intensiva."},{"key":"B17","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s13054-021-03463-2","article-title":"Insight into ECMO, mortality and ARDS: a nationwide analysis of 45,647 ECMO runs","volume":"25","author":"Friedrichson","year":"2021","journal-title":"Crit Care."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e0260324","DOI":"10.1371\/journal.pone.0260324","article-title":"ECMO use in Germany: an analysis of 29,929 ECMO runs","volume":"16","author":"Bercker","year":"2021","journal-title":"PLoS ONE."},{"key":"B19","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13613-017-0275-4","article-title":"Systematic review and meta-analysis of complications and mortality of veno-venous extracorporeal membrane oxygenation for refractory acute respiratory distress syndrome","volume":"7","author":"Vaquer","year":"2017","journal-title":"Ann Intensive Care."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.1056\/NEJMoa1800385","article-title":"Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome","volume":"378","author":"Combes","year":"2018","journal-title":"N Engl J Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1186\/s13054-024-05074-z","article-title":"Role of age as eligibility criterion for ECMO in patients with ARDS: meta-regression analysis","volume":"28","author":"Tonetti","year":"2024","journal-title":"Crit Care."},{"key":"B22","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/j.ihj.2017.05.003","article-title":"The impact of severity of initial illness, determined by SOFA score, and presence of anemia on outcomes among patients requiring Extra Corporal Membrane Oxygenation (ECMO) support: A single center experience","volume":"69","author":"Elabbassi","year":"2017","journal-title":"Indian Heart J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1177\/02676591231178896","article-title":"Obesity associated with improved mortality of extracorporeal membrane oxygenation for severe COVID-19 pneumonia","volume":"39","author":"Prasad","year":"2024","journal-title":"Perfusion."},{"key":"B24","doi-asserted-by":"publisher","first-page":"474","DOI":"10.4187\/respcare.11565","article-title":"Obesity and Extracorporeal Membrane Oxygenation","volume":"69","author":"Coccola","year":"2024","journal-title":"Respir Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"E513","DOI":"10.1097\/MAT.0000000000002047","article-title":"Extracorporeal life support for patients with newly diagnosed HIV and acute respiratory distress syndrome: a systematic review and analysis of individual patient data","volume":"69","author":"Rajsic","year":"2023","journal-title":"ASAIO J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1164\/rccm.201708-1761OC","article-title":"Six-month outcome of immunocompromised patients with severe acute respiratory distress syndrome rescued by extracorporeal membrane oxygenation. An international multicenter retrospective study","volume":"197","author":"Schmidt","year":"2018","journal-title":"Am J Respir Crit Care Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1007\/s00134-025-07890-5","article-title":"Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high-flow nasal oxygen","volume":"51","author":"Azoulay","year":"2025","journal-title":"Intensive Care Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1513\/pats.201009-060WR","article-title":"Critical illness in HIV-infected patients in the era of combination antiretroviral therapy","volume":"8","author":"Akg\u00fcn","year":"2011","journal-title":"Proc Am Thorac Soc."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002589","article-title":"Renal angina index as a predictor of renal injury progression in patients on extracorporeal membrane oxygenation support: the DREAMS Study","author":"Perez-Garzon","year":"2025","journal-title":"ASAIO J."},{"key":"B30","doi-asserted-by":"publisher","first-page":"29609","DOI":"10.1161\/JAHA.123.029609","article-title":"Patient and management variables associated with survival after postcardiotomy extracorporeal membrane oxygenation in adults: the PELS-1 multicenter cohort study","volume":"12","author":"Mariani","year":"2023","journal-title":"J Am Heart Assoc."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1829427\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:21:05Z","timestamp":1780899665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1829427\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":30,"alternative-id":["10.3389\/fmed.2026.1829427"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1829427","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"article-number":"1829427"}}