ORIGINAL ARTICLE   Free access

Minerva Anestesiologica 2017 May;83(5):493-501

DOI: 10.23736/S0375-9393.17.11659-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Nosocomial blood stream infections in patients treated with venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome

Marko KUTLEŠA ^{1, 2}, Marija SANTINI ^{1, 2}, Vladimir KRAJINOVIĆ ², Neven PAPIĆ ², Anđa NOVOKMET ², Renata JOSIPOVIĆ MRAOVIĆ ², Bruno BARŠIĆ ^{1, 2} ✉

¹ Unit of Infectious Diseases, School of Medicine, University of Zagreb, Zagreb, Croatia; ² Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia

BACKGROUND: The incidence of complication rates in patients treated with venovenous extracorporeal membrane oxygenation (VV ECMO) remains substantial and impacts the results of any future trial dealing with ECMO efficacy. Of these complications blood stream infections (BSI) are less well studied. Our objective was to report influence of BSI in ARDS patients treated with VV ECMO.
METHODS: One-hundred adult patients with ARDS treated with VV ECMO at the tertiary care hospital in Zagreb, Croatia between the October of 2009 and the June of 2016 were prospectively included in the study.
RESULTS: In 35% of patients an episode of the nosocomial BSI during VV ECMO treatment was detected. ECMO duration of more than 250 hours and significant bleeding episode independently increase the possibility of acquiring BSI during an ECMO run (odds ratio 3.189, 95% confidence limits 1.108-9.180 and odds ratio 3.378, 95% confidence limits 1.055-10.869 respectively). BSI occurrence had no effect on mortality.
CONCLUSIONS: Our study found that BSI incidence increases with the duration of an ECMO run and bleeding complications with no effect on hospital mortality. Further studies of BSI in this risk group should address the problem of rapid diagnosis and appropriate antimicrobial therapy in an era of growing multiresistance.

KEY WORDS: Extracorporeal membrane oxygenation - Respiratory distress syndrome, adult - Cross infection