- Author: Hae In Ko, Min Cheol Kim, Yongwhan Lim, Hwa Jin Cho, Seong Eun Kim, Do Wan Kim, In Seok Jeong
- Date: 2023/09/01
- Journal: ASAIO Journal;69(Suppl 3);18
- PMID:
- PMCID:
- DOI: 10.1097/01.mat.0000990660.33408.e9
Abstract
Introduction: Extracorporeal membrane oxygenation (ECMO) is an essential therapy for severe cardiopulmonary failure. However, the risk factors and impact of nosocomial infections (NI) during ECMO on prognosis have yet to be adequately studied. In this study, we aimed to evaluate the incidence and effects of NI, including multidrug-resistant infections, on clinical outcomes in adult patients undergoing venoarterial (VA) ECMO following acute coronary syndrome (ACS).
Methods: We conducted a retrospective analysis of medical records from January 2016 to December 2022 involving 172 adult patients who underwent VA ECMO for ACS-induced cardiogenic shock. These patients were categorized into the NI group and the non-NI group. Risk factors for NI were analyzed, and clinical outcomes were compared between the two groups.
Results: The median age of the patients was 69 years, with 23.8% being women. The incidence of NI was 21.31 cases per 1,000 ECMO-day. Multivariate analysis revealed that younger age, lower Glasgow Coma Scale, utilization of intra-ECMO renal replacement treatment (RRT), and absence of multidisciplinary care were significant risk factors for NI (Fig. 1). And the two groups had no significant difference in survival rate at discharge (p=0.103) (Fig. 2).
Conclusion: We found that a longer duration of ECMO and RRT was associated with an increased risk of NI. Additionally, we identified that multidisciplinary care plays a crucial role in reducing the occurrence of NI.