Incidence of nosocomial infections in adult patients undergoing extracorporeal membrane oxygenation.
INTRODUCTION: 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.
METHODS: 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.
RESULTS: 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; p10 days was compared with ≤10 days (28.5% vs. 43.1%; p=0.154).
CONCLUSION: Nosocomial infections have no effect on survival in adult ECMO patients. Presence of either antibiotics or infection prior to ECMO has no effect on developing nosocomial infections while on ECMO. Duration of ECMO longer than 10 days is a major risk factor for developing nosocomial infection.
Published In/Presented At
Juthani, B. K., Macfarlan, J. E., Wu, J. K., Misselbeck, T. S. (2018). Incidence of nosocomial infections in adult patients undergoing extracorporeal membrane oxygenation. Heart & lung : the journal of critical care, 47(6), 626-630. doi: 10.1016/j.hrtlng.2018.07.004
Department of Surgery, Department of Surgery Faculty, Network Office of Research and Innovation