Incidence of nosocomial infections in adult patients undergoing extracorporeal membrane oxygenation

Heart & Lung : the Journal of Critical Care
Biren K JuthaniTimothy S Misselbeck

Abstract

Critically ill patients requiring extracorporeal membrane oxygenation (ECMO) are at increased risk for developing nosocomial infections owing to their underlying disease process along with numerous invasive monitoring devices. We retrospectively analyzed the rate, type, pathogens, outcomes, and risk factors of nosocomial infections that developed during adult patients on ECMO at our institution from 2012-2015. Compared to current ELSO reported adult nosocomial infections rate of 20.5%, we report our rate of 26% (CI 17.2%-34.7%). No significant differences were observed in mortality (42.3% vs. 36.5%; p=0.598), and presence of either antibiotics prior to ECMO (57.7% vs. 56.7%; p=0.934) or culture-proven infection prior to ECMO (19.2% vs. 32.4%; p=0.201). Patients who developed nosocomial infections had longer duration of ECMO (13 vs. 5 days; p<0.001), longer length of stay (36.5 vs. 18.5 days; p=0.004), and more days on ventilator (29 vs. 12.5; p=0.002). Duration of ECMO (OR=1.20, 95% CI 1.02-1.39; p=0.020) and duration of ECMO greater than 10 days (OR=14.65, 95% CI 1.81-118.78; p=0.012) were independent risk factors for developing nosocomial infections. However, there was no difference in mortality when duration of ECMO >10 days...Continue Reading

Citations

Dec 29, 2020·The Annals of Thoracic Surgery·Megan T QuintanaJoseph Rabin
May 11, 2020·Hellenic Journal of Cardiology : HJC = Hellēnikē Kardiologikē Epitheōrēsē·Marinos KosmopoulosDemetris Yannopoulos
Jul 3, 2021·Infection and Drug Resistance·Zhan-Jie LiWei-Hong Zhang
Jun 29, 2021·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Joseph E MarcusAlice E Barsoumian

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