Obesity paradox refers to lower mortality in subjects with higher body mass index BMI , and has been documented under a variety of condition. However, whether obesity paradox exists in adults requiring mechanical ventilation in intensive critical units ICU remains controversial.
A random-effects model was used for data analyses. Risk of bias was assessed using the Newcastle-Ottawa quality assessment scale. A total of 15, articles were screened. The final analysis included 23 articles , subjects. Hospital mortality was lower in severely obese and obese subjects OR 0. Short-term mortality was lower in overweight and obese subjects OR 0. Long-term mortality was lower in severely obese, obese and overweight subjects OR 0.
All 4 mortality measures were higher in underweight subjects than in subjects with normal BMI. Obese subjects had significantly longer duration on mechanical ventilation than non-obese group mean difference MD 0. In ICU patients receiving mechanical ventilation, higher BMI is associated with lower mortality and longer duration on mechanical ventilation.
