Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit

The use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in...

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Detalhes bibliográficos
Autores: Mornese Pinna, Simone, Sousa Casasnovas, Iago, Olmedo, María, Machado, Marina, Juàrez Fernández, Miriam, Devesa Cordero, Carolina, Galar, Alicia, Álvarez Uría, Ana, Fernández Avilés, Francisco, García Carreño, Jorge, Martínez-Sellés D Oliveira Soares, Manuel, De Rosa, Francesco Giuseppe, Corcione, Silvia, Bouza Santiago, Emilio, Muñoz García, Patricia Carmen, Valerio Minero, Maricela
Tipo de documento: artigo
Data de publicação:2023
País:España
Recursos:Universidad Complutense de Madrid (UCM)
Repositório:Docta Complutense
Idioma:inglês
OAI Identifier:oai:docta.ucm.es:20.500.14352/104864
Acesso em linha:https://hdl.handle.net/20.500.14352/104864
Access Level:Acceso aberto
Palavra-chave:616.9
616-036.22
ECMO
Venoarterial extracorporeal membrane oxygenation
Nosocomial infections
Cardiac intensive care unit
Cardiovascular infections
Enfermedades infecciosas
Microbiología médica
3201.03 Microbiología Clínica
3202 Epidemiología
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oai_identifier_str oai:docta.ucm.es:20.500.14352/104864
network_acronym_str ES
network_name_str España
repository_id_str
spelling Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unitMornese Pinna, SimoneSousa Casasnovas, IagoOlmedo, MaríaMachado, MarinaJuàrez Fernández, MiriamDevesa Cordero, CarolinaGalar, AliciaÁlvarez Uría, AnaFernández Avilés, FranciscoGarcía Carreño, JorgeMartínez-Sellés D Oliveira Soares, ManuelDe Rosa, Francesco GiuseppeCorcione, SilviaBouza Santiago, EmilioMuñoz García, Patricia CarmenValerio Minero, Maricela616.9616-036.22ECMOVenoarterial extracorporeal membrane oxygenationNosocomial infectionsCardiac intensive care unitCardiovascular infectionsEnfermedades infecciosasMicrobiología médica3201.03 Microbiología Clínica3202 EpidemiologíaThe use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01–1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05–14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12–60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23–3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients.MDPIUniversidad Complutense de Madrid20232023-04-2020232023-04-20journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/104864reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1048642026-06-02T12:44:21Z
dc.title.none.fl_str_mv Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
title Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
spellingShingle Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
Mornese Pinna, Simone
616.9
616-036.22
ECMO
Venoarterial extracorporeal membrane oxygenation
Nosocomial infections
Cardiac intensive care unit
Cardiovascular infections
Enfermedades infecciosas
Microbiología médica
3201.03 Microbiología Clínica
3202 Epidemiología
title_short Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
title_full Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
title_fullStr Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
title_full_unstemmed Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
title_sort Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
dc.creator.none.fl_str_mv Mornese Pinna, Simone
Sousa Casasnovas, Iago
Olmedo, María
Machado, Marina
Juàrez Fernández, Miriam
Devesa Cordero, Carolina
Galar, Alicia
Álvarez Uría, Ana
Fernández Avilés, Francisco
García Carreño, Jorge
Martínez-Sellés D Oliveira Soares, Manuel
De Rosa, Francesco Giuseppe
Corcione, Silvia
Bouza Santiago, Emilio
Muñoz García, Patricia Carmen
Valerio Minero, Maricela
author Mornese Pinna, Simone
author_facet Mornese Pinna, Simone
Sousa Casasnovas, Iago
Olmedo, María
Machado, Marina
Juàrez Fernández, Miriam
Devesa Cordero, Carolina
Galar, Alicia
Álvarez Uría, Ana
Fernández Avilés, Francisco
García Carreño, Jorge
Martínez-Sellés D Oliveira Soares, Manuel
De Rosa, Francesco Giuseppe
Corcione, Silvia
Bouza Santiago, Emilio
Muñoz García, Patricia Carmen
Valerio Minero, Maricela
author_role author
author2 Sousa Casasnovas, Iago
Olmedo, María
Machado, Marina
Juàrez Fernández, Miriam
Devesa Cordero, Carolina
Galar, Alicia
Álvarez Uría, Ana
Fernández Avilés, Francisco
García Carreño, Jorge
Martínez-Sellés D Oliveira Soares, Manuel
De Rosa, Francesco Giuseppe
Corcione, Silvia
Bouza Santiago, Emilio
Muñoz García, Patricia Carmen
Valerio Minero, Maricela
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 616.9
616-036.22
ECMO
Venoarterial extracorporeal membrane oxygenation
Nosocomial infections
Cardiac intensive care unit
Cardiovascular infections
Enfermedades infecciosas
Microbiología médica
3201.03 Microbiología Clínica
3202 Epidemiología
topic 616.9
616-036.22
ECMO
Venoarterial extracorporeal membrane oxygenation
Nosocomial infections
Cardiac intensive care unit
Cardiovascular infections
Enfermedades infecciosas
Microbiología médica
3201.03 Microbiología Clínica
3202 Epidemiología
description The use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01–1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05–14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12–60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23–3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-04-20
2023
2023-04-20
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/104864
url https://hdl.handle.net/20.500.14352/104864
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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